Raudrant D, Frappart L, Fournier S
Service de Gynécologie-Obstétrique, Hôtel-Dieu, Lyon.
Rev Fr Gynecol Obstet. 1987 Dec;82(12):751-6.
A review of the literature concerning atypical hyperplasias of the endometrium is presented. The new pathological classifications differentiate structural abnormalities from cellular abnormalities. For atypical hyperplasias with cellular abnormalities, similar classifications to that of Richard for the cervix have been proposed: Intra Endometrial Neoplasia (IEN) grades I to III. Evolution of these lesions toward endometrial adenocarcinoma must guide the treatment. In prospective studies, atypical hyperplasias with structural abnormalities evolve into adenocarcinoma in 1.6 to 22 per cent of the cases. In atypical hyperplasia with cellular abnormalities, they evolve into adenocarcinoma in 23 to 57 per cent of the cases, according to the authors. Total hysterectomy is the treatment which is the most suitable for atypical hyperplasias with cellular abnormalities. Continuous progestational medications before menopause and the same given intermittently before menopause, represent the possible medical treatments.
本文对有关子宫内膜非典型增生的文献进行了综述。新的病理分类将结构异常与细胞异常区分开来。对于具有细胞异常的非典型增生，有人提出了与理查德对宫颈病变类似的分类：子宫内膜内瘤变（IEN）I至III级。这些病变向子宫内膜腺癌的演变必须指导治疗。在前瞻性研究中，具有结构异常的非典型增生在1.6%至22%的病例中会演变为腺癌。据作者称，在具有细胞异常的非典型增生中，23%至57%的病例会演变为腺癌。全子宫切除术是最适合具有细胞异常的非典型增生的治疗方法。绝经前持续使用孕激素药物以及绝经前间歇性使用相同药物是可能的药物治疗方法。
