Complexity of glandular architecture should be reconsidered in the classification and management of endometrial hyperplasia

被引:39
作者
Travaglino, Antonio [1 ]
Raffone, Antonio [2 ]
Saccone, Gabriele [2 ]
Mollo, Antonio [2 ]
De Placido, Giuseppe [2 ]
Mascolo, Massimo [1 ]
Insabato, Luigi [1 ]
Zullo, Fulvio [2 ]
机构
[1] Univ Naples Federico II, Sch Med, Dept Adv Biomed Sci, Anat Pathol Unit, Naples, Italy
[2] Univ Naples Federico II, Sch Med, Dept Neurosci Reprod Sci & Dent, Gynecol & Obstet Unit, Via Sergio Pansini 5, I-80131 Naples, Italy
关键词
World Health Organization; endometrial intraepithelial neoplasia; endometrioid adenocarcinoma; endometrial precancer; atypical endometrial hyperplasia; INTRAEPITHELIAL-NEOPLASIA CLASSIFICATION; LONG-TERM; PREDICTION; RISK; CARCINOMA; CANCER;
D O I
10.1111/apm.12945
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The 2014 World Health Organization (WHO) classification of endometrial hyperplasia (EH) defines premalignant EH based on only cytologic atypia, disregarding architecture complexity. We aimed to assess the impact of architecture complexity on the risk of cancer in non-atypical EH. A systematic review and meta-analysis was performed by searching electronic databases form their inception to October 2018. All studies assessing the rates of progression to cancer in non-atypical EH (simple vs complex) were included. Pooled relative risk (RR) for cancer progression was calculated; a p-value EH to cancer was significantly higher in complex EH than in simple EH (p < 0.0001), with an RR of 4.90. In conclusion, the complexity of glandular architecture significantly increases the risk of cancer in non-atypical EH. Complex non-atypical EH may be regarded as a low-risk premalignant lesion rather than a benign condition.
引用
收藏
页码:427 / 434
页数:8
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