title: High prevalence of atypical hyperplasia in the endometrium of patients with epithelial ovarian cancer.
abstract: OBJECTIVE
  The aim of the present study is to determine the prevalence of endometrial premalignancies in women diagnosed with epithelial ovarian cancer (EOC).
  
  
  METHODS
  Endometrial and ovarian specimens of 186 patients with EOC were retrospectively selected using the nationwide pathology network and registry, and sections were comprehensively reviewed: 136 (73%) serous, 19 (10%) endometrioid, 15 (8%) mucinous, seven (4%) clear cell, and nine (5%) undifferentiated. Immunohistochemical phenotypes were compared for patients with serous EOC with concurrent endometrial pathology.
  
  
  RESULTS
  In 31%, endometrial (pre)malignancy was found: carcinoma in 3%, endometrial intraepithelial carcinoma (EIC) in 4%, and atypical hyperplasia in 24%. Atypical hyperplasia was found in 47% of endometrioid EOCs but in 7% to 33% of other subtypes. Body mass index was higher concurrent to atypical hyperplasia (P=.001). Serous EOC and EIC immunophenotypes were comparable, whereas atypical hyperplasia was expressed differently.
  
  
  CONCLUSIONS
  Apart from synchronous endometrial carcinoma, endometrial premalignancies should be taken into account when determining optimal treatment for women diagnosed with EOC.
authors.affiliation: From the Departments of Obstetrics and Gynecology and M.Mingels@obgyn.umcn.nl.
authors.forename: Marjanka J J M
authors.initials: MJ
authors.lastname: Mingels
authors.affiliation: Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Department of Pathology, Hasanuddin University, Makassar, Indonesia; and.
authors.forename: Rina
authors.initials: R
authors.lastname: Masadah
authors.affiliation: From the Departments of Obstetrics and Gynecology and.
authors.forename: Yvette P
authors.initials: YP
authors.lastname: Geels
authors.affiliation: Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands;
authors.forename: Irene
authors.initials: I
authors.lastname: Otte-Höller
authors.affiliation: Department of Pathology, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands.
authors.forename: Ineke M
authors.initials: IM
authors.lastname: de Kievit
authors.affiliation: Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands;
authors.forename: Jeroen A W M
authors.initials: JA
authors.lastname: van der Laak
authors.affiliation: From the Departments of Obstetrics and Gynecology and.
authors.forename: Maaike A P C
authors.initials: MA
authors.lastname: van Ham
authors.affiliation: Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands;
authors.forename: Johan
authors.initials: J
authors.lastname: Bulten
authors.affiliation: From the Departments of Obstetrics and Gynecology and.
authors.forename: Leon F A G
authors.initials: LF
authors.lastname: Massuger
mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D004717:Endometrium / Q000378:metabolism*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000453:epidemiology* / Q000473:pathology; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000628:therapy; D011230:Precancerous Conditions / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies
keywords: Atypical hyperplasia; Endometrial intraepithelial carcinoma; Endometrium; Epithelial ovarian cancer