[Endometrial hyperplasia, diagnosis. Clinical, paraclinical exam and management].
Factors associated with unopposed estrogenic stimulation such as obesity, exogenous hormone use endometrial hyperplasia are related to the development of the most common form of endometrial carcinoma, that is, the endometroid subtype.


METHODS
We selected a group of patients diagnosed with endometrial hyperplasia by endometrial biopsy and histopathological examination. The main complaint in all cases was abnormal uterine bleeding. All patients had gynecological examination, vaginal ultrasound, hysteroscopy endometrial biopsy or D&C. 32 patients had also immunohistochemical staining for Ki67, EGF, ER, PGR.


RESULTS
Cases with ages between 24-67 years were classified as: 100 simple hyperplasia, 10 complex hyperplasia, 43 atypical simple hyperplasia, 7 atypical complex hyperplasia. PR were 40-60% at all forms of hyperplasia, E2R were 30-40% in simple hyperplasia without atypia and 50-70% in complex hyperplasia without atypia. Correlation between immunohistochemical expression of E2R, PGR, Ki-67, EGF and body mass revealed an high immunohistochemical expression of E2R and Ki-67 in patients with hyperplasia without atypia and a low expression and high reactivity of EGF in cases with high body mass.


CONCLUSIONS
Vaginal ultrasound and hysteroscopy are efficacious completion for histopathological diagnosis. We recommend an age/risk appropriate screening to detect risk factors and early disease in the asymptomatic patients.
Pangal
Alexandra
A
Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi Facultatea de Medicină Dentară, Disciplina Obstetrică Ginecologie.
Costăchescu
Gh
G
Aldea
Marie Jeanne
MJ
D000328:Adult; D000368:Aged; D001706:Biopsy; D015992:Body Mass Index; D004714:Endometrial Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D019160:Endosonography; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy; D007150:Immunohistochemistry; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000209:etiology