Endometrial Biyopsi Sonucu Endometrial Hiperplazi ve Endometrial İntraepitelyal Neoplazi Olarak Raporlanan Hasta Gruplarının Histerektomi Materyallerinde Endometrium Kanser Oranının Karşılaştırılması

Abstract

Objective: The objective of this study was to compare the coexistent cancer rates between two classification systems World Health Organization system (WHO 94) and endometrial intraepithelial neoplasia (EIN) system in surgically treated patients. Methods: This study includes the patients who applied to Hacettepe University Gynecology Clinic between 2002 and 2014. Biopsy and hysterectomy specimens of 274 women who were subjected to surgery with a preoperative diagnosis of precancerous lesions according to the WHO and EIN systems were evaluated retrospectively. Women diagnosed any malignancy except endometrium cancer were excluded, 267 patients remained. The coexisting endometrial adenocarcinoma rate in hysterectomy materials was determined separately for WHO and EIN groups and then two groups were compared. Results: Among the 267 patients 189 (70.8%) were in WHO 94 group and 78 (29.2%) were in EIN group at biopsy specimens. Patients’age, menopausal status and complaints were similar in two groups. 146 women (77.2%) had non- atypical endometrial hyperplasia (EH) and 43 women (22.8%) had atypical EH in WHO 94 group. Thirty-one women (11.6%) had endometrial cancer. Endometrial cancer was detected in 16 patients (8.5%) in WHO 94 group and in 15 patients (19.2%) in EIN group (p=0.013). In WHO 94 group, the rate of coexistent endometrial cancer was 32.6%in women with atypical EH and 1.4%in women with non- atypical EH (p<0.001). Conclusion: Patients with endometrial precancerous lesions are associated with significant rates of coexisting endometrial cancer. Thus patients diagnosed with atypical EH or EIN should be treated with surgical approach if they are postmenopausal or do not desire fertility at premenopausal age.