LOGO
pl en

Histopathological diagnosis of endometrial hyperplasia. Part I

Anna Nasierowska-Guttmejer1, Wiesława Grajkowska2, Krzysztof Bardadin3

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2009, 7 (3), p. 154-160
Streszczenie

Bleeding from uterine cavity in peri- or postmenopausal women is usually the first symptom of endometrial hyperplasia. Endometrial cells are very sensitive to estrogen stimulation. Endo- or exogenous estrogen stimulation results in simple endometrial hyperplasia without atypia, hyperplasia with atypia (precancerous condition) to endometrial cancer. The key issue in histopathological diagnosis of endometrial hyperplasia is differentiation between hyperplasia and precancerous condition and frank cancer. Widely used WHO classification of endometrial hyperplasia not always enables selection of relatively homogenous groups of patients with a similar prognosis. Therefore, an alternative clinically useful classification has been developed, distinguishing between benign endometrial hyperplasia justifying hormonal therapy and endometrial intraepithelial neoplasia (EIN), which is a precancerous condition warranting both hormonal and surgical treatment. The product of suppressor gene PTEN is considered a biological marker of precancerous cellular clone. In some cases, to improve objectivism of interpretation of microscopic images, histopathological study may be supplemented by immunohistochemical assay of PTEN expression. From the clinical point of view, an important point is that subdivision of EIN has significant practical implications. It enables sorting out of groups of patients depending on prognosis and risk of development of cancer, and also helps to determine the best treatment modality. An indispensable prerequisite for a correct histopathological diagnosis of endometrial hyperplasia is a close cooperation between pathologists and gynecologists. Clinical data concerning the patient’s age, date of last menses and hormonal status have a significant influence on interpretation of microscopic image of endometrial biopsy.

Słowa kluczowe
endometrial hyperplasia, endometrial precancerous condition, uterine bleeding, endometrial intraepithelial neoplasia (EIN), endometrial intraepithelial cancer (EIC)