Departments of Obstetrics and Gynecology, University Hospitals Case Medical Center, Euclid Ave, Cleveland, OH 44106, USA.
J Minim Invasive Gynecol. 2012 Sep-Oct;19(5):562-71. doi: 10.1016/j.jmig.2012.05.009. Epub 2012 Aug 3.
Endometrial hyperplasia (EH), with or without atypia, is a common gynecologic diagnosis and a known precursor of endometrial carcinoma, the most common gynecologic malignancy. During the reproductive years, the risk of EH is increased by conditions associated with intermittent or absent ovulation, in particular, polycystic ovary syndrome. After menopause when ovulation has ceased, EH is more common in women with conditions that increase levels of circulating estrogen such as obesity or estrogen replacement therapy. Women with EH are at increased risk for both concurrent and subsequent endometrial cancer. The risk of coexisting cancer in women with a diagnosis of EH at endometrial sampling is due to limitations in both endometrial sampling and the diagnostic reproducibility among pathologists. These diagnostic uncertainties add to the complexity of managing EH. This review offers a rational approach to prevention, diagnosis, and treatment of EH, including hormone therapy and conservative surgical methods.
子宫内膜增生（EH），伴或不伴非典型性，是一种常见的妇科诊断，也是子宫内膜癌的已知前体，子宫内膜癌是最常见的妇科恶性肿瘤。在生育期，与间歇性或无排卵相关的疾病会增加 EH 的风险，特别是多囊卵巢综合征。绝经后排卵停止时，肥胖或雌激素替代治疗等导致循环雌激素水平升高的疾病会使 EH 更为常见。EH 患者同时或随后发生子宫内膜癌的风险增加。在子宫内膜取样时诊断为 EH 的女性中同时存在癌症的风险是由于子宫内膜取样和病理学家之间的诊断可重复性存在局限性。这些诊断上的不确定性增加了 EH 管理的复杂性。本综述提供了一种合理的方法来预防、诊断和治疗 EH，包括激素治疗和保守性手术方法。
