Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark.
Department of Pathology, Randers Regional Hospital, Randers, Denmark.
PLoS One. 2022 Apr 12;17(4):e0266339. doi: 10.1371/journal.pone.0266339. eCollection 2022.
The strong association between atypical endometrial hyperplasia and endometrial carcinoma is well established, but data on the risk of atypical hyperplasia and carcinoma in Danish women with non-atypical endometrial hyperplasia are almost non-existent. This study aimed to investigate the prevalence of atypical hyperplasia and endometrial carcinoma diagnosed within 3 months of initial diagnosis (defined as concurrent disease) and the risk of atypical hyperplasia and carcinoma more than 3 months after initial diagnosis (classified as progressive disease) in Danish women initially diagnosed with non-atypical endometrial hyperplasia.
This cohort study recruited 102 women diagnosed with non-atypical endometrial hyperplasia at Randers Regional Hospital in Randers, Denmark, between 2000 and 2015.
The endometrium was evaluated by transvaginal ultrasound examination and office mini-hysteroscopy with biopsies in all non-hysterectomized women. Data regarding subsequent hysterectomy or endometrial sampling were obtained from medical records and the Danish Pathology Registry (Patobank).
A total of 15 women were diagnosed with atypical hyperplasia or carcinoma during follow-up. Concurrent atypical hyperplasia or carcinoma was seen in 2.9% (3/102), and among women who remained at risk for more than 3 months after initial diagnosis of non-atypical endometrial hyperplasia (n = 94), progression to atypical hyperplasia or carcinoma was seen in 13% (median follow-up 5.2 years, range 3.6 months to 15.1 years). Sixty-six percent of the women with progressive disease were diagnosed with atypical hyperplasia or carcinoma more than 1 year after initial diagnosis, but only two were diagnosed later than 5 years (5.2 and 9 years).
The risk of being diagnosed with atypical endometrial hyperplasia or endometrial carcinoma more than 5 years after an initial diagnosis of non-atypical endometrial hyperplasia seems to be low in Danish women. Specialized follow-up more than 5 years after diagnosis of non-atypical endometrial hyperplasia may not be warranted.
非典型子宫内膜增生与子宫内膜癌之间存在很强的关联性，这一点已得到充分证实，但是丹麦非典型子宫内膜增生患者中，关于非典型增生和癌的风险数据几乎不存在。本研究旨在调查丹麦女性中，在初始诊断后 3 个月内诊断出的非典型增生和癌（定义为并发疾病）的患病率，以及初始诊断后 3 个月以上诊断出的非典型增生和癌（归类为进展性疾病）的风险。
这项队列研究招募了 2000 年至 2015 年期间在丹麦兰讷斯地区医院诊断为非典型子宫内膜增生的 102 名女性。
所有未行子宫切除术的女性均通过经阴道超声检查和办公室迷你宫腔镜检查及活检来评估子宫内膜。随后通过病历和丹麦病理登记处（Patobank）获取关于进一步子宫切除术或子宫内膜取样的数据。
共有 15 名女性在随访期间被诊断为非典型增生或癌。并发非典型增生或癌的比例为 2.9%（3/102），在初始非典型子宫内膜增生诊断后仍有 3 个月以上风险的女性（n=94）中，进展为非典型增生或癌的比例为 13%（中位随访时间为 5.2 年，范围 3.6 个月至 15.1 年）。进展性疾病患者中有 66%在初始诊断后 1 年以上被诊断为非典型增生或癌，但只有 2 例在 5 年后被诊断（分别为 5.2 年和 9 年）。
在丹麦女性中，初始诊断为非典型子宫内膜增生后 5 年以上被诊断为非典型子宫内膜增生或子宫内膜癌的风险似乎较低。在初始诊断为非典型子宫内膜增生后 5 年以上进行专门的随访可能没有必要。
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