Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.
Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
Arch Gynecol Obstet. 2019 Nov;300(5):1147-1154. doi: 10.1007/s00404-019-05299-2. Epub 2019 Sep 17.
In the 2014 WHO classification of endometrial hyperplasia (EH), complex EH is lumped together with simple EH in the benign category of non-atypical EH.
To assess the risk of coexistent cancer in complex EH and simple EH without atypia, through a systematic review and meta-analysis.
Electronic databases were searched from their inception to January 2019 for relevant articles.
Twelve studies assessing a total of 804 non-atypical EH were included. The risk of coexistent cancer was significantly higher in complex EH (12.4%) than in simple EH (2%), with an OR of 6.03 (p = 0.0002).
Even in the absence of cytologic atypia, complex EH is associated with a significant risk of coexistent cancer. Further studies are necessary to investigate the need for a revision in the WHO classification.
在 2014 年世界卫生组织（WHO）子宫内膜增生症（EH）分类中，复杂型 EH 与非典型单纯性 EH 一起被归入良性非典型 EH 类别。
通过系统评价和荟萃分析，评估不伴非典型性的复杂型 EH 和单纯型 EH 中同时存在癌症的风险。
从数据库建立之初至 2019 年 1 月，对相关文献进行电子检索。
共纳入 12 项研究，总计 804 例非典型 EH。复杂型 EH（12.4%）同时存在癌症的风险明显高于单纯型 EH（2%），比值比（OR）为 6.03（p=0.0002）。
即使没有细胞学非典型性，复杂型 EH 也与同时存在癌症的风险显著相关。有必要进一步研究以探讨是否需要修订 WHO 分类。
