Caserta D, Matteucci E, Ralli E, Mallozzi M, Bordi G, Moscarini M
Eur J Gynaecol Oncol. 2014;35(1):97-9.
The standard treatment for complex atypical hyperplasia is hysterectomy and bilateral salpingo-oophorectomy. Although radical surgery offers high survival prospects, it also eliminates any chance of further fertility, thus in young nulliparous women who wish to preserve their childbearing potential, a conservative progestin therapy is preferable.
The authors report a case of complex atypical hyperplasia in a 29-year-old nulliparous woman with polycystic ovary syndrome treated with norethisterone acetate in order to preserve her childbearing potential. The specimens sampled during the follow-up demonstrated inactive endometrium with pseudodecidual changes and no ultrasonographic images exhibited abnormal endometrial thickness.
According to literature and to the authors' experience, they can affirm that progestin treatment is the most reasonable option for young nulliparous women affected by complex atypical hyperplasia who desire to maintain their fertility potential, showing its efficacy also in patients with an associated polycystic ovary syndrome.
复杂非典型增生的标准治疗方法是子宫切除术和双侧输卵管卵巢切除术。尽管根治性手术有较高的生存前景，但它也消除了进一步生育的任何机会，因此对于希望保留生育潜力的年轻未生育女性来说，保守的孕激素治疗更为可取。
作者报告了一例29岁患有多囊卵巢综合征的未生育女性的复杂非典型增生病例，该患者接受了醋酸炔诺酮治疗以保留其生育潜力。随访期间采集的标本显示子宫内膜呈静止状态，有假蜕膜样改变，且超声图像未显示子宫内膜厚度异常。
根据文献和作者的经验，他们可以肯定，对于希望维持生育潜力的患有复杂非典型增生的年轻未生育女性，孕激素治疗是最合理的选择，并且在伴有多囊卵巢综合征的患者中也显示出了疗效。
