Современный взгляд на тактику ведения пациенток с гиперплазией эндометрия

1. Гиперплазия эндометрия. Клинические рекомендации. 2021 г. Режим доступа: https://cr.minzdrav.gov.ru/recomend/646_1. Ссылка активна на 15.09.2023 [Endometrial hyperplasia. Clinical recommendations. 2021. Available at: https://cr.minzdrav.gov.ru/recomend/646_1. Accessed: 15.09.2023 (in Russian)].
2. Коган Е.А., Унанян А.Л., Намиот В.А., и др. Прецизионный подход к диагностике и выбору тактики лечения гиперплазии эндометрия в перимонопаузе. Биофизика. 2019;4:811-20 [Kogan EA, Unanyan AL, Namiot VA, et al. A precision approach to the diagnosis and choice of tactics for the treatment of endometrial hyperplasia in perimonopause. Biophysics. 2019;4:811-20 (in Russian)].
3. Sanderson PA, Critchley HO, Williams AR, et al. New concepts for an old problem: the diagnosis of endometrial hyperplasia. Hum Reprod Update. 2017;23(2):232-54. DOI:10.1093/humupd/dmw042
4. Габидуллина Р.И., Смирнова Г.А., Нухбала Ф.Р., и др. Гиперпластические процессы эндометрия: современная тактика ведения пациенток. Гинекология. 2019;21(6):53-8 [Gabidullina RI, Smirnova GA, Nuhbala FR, et al. Hyperplastic processes of the endometrium: modern management tactics of patients. Gynecology. 2019;21(6):53-8 (in Russian)]. DOI:10.26442/20795696.2019.6.190472 
5. Tian Y, Liu Y, Wang G, et al. Endometrial hyperplasia in infertile women undergoing IVF/ICSI: A retrospective cross-sectional study. J Gynecol Obstet Hum Reprod. 2020:101780. DOI:10.1016/j.jogoh.2020.101780
6. Hutt S, Tailor A, Ellis P, et al. The role of biomarkers in endometrial cancer and hyperplasia: a literature review. Acta Oncol. 2019;58(3):342-52. DOI:10.1080/0284186X.2018.1540886
7. Russo M, Newell JM, Budurlean L, et al. Mutational profile of endometrial hyperplasia and risk of progression to endometrioid adenocarcinoma. Cancer. 2020;126(12):2775-83. DOI:10.1002/cncr.32822
8. Маринкин И.О., Лисова Е.С., Евченко В.В. Клеточно-молекулярные особенности гиперплазии эндометрия в условиях воздействия производственных токсических факторов. Медицина труда и промышленная экология. 2019;59(9):690 [Marinkin IO, Lisova ES, Evchenko VV. Cellular and molecular features of endometrial hyperplasia under the influence of industrial toxic factors. Occupational Medicine and Industrial Ecology. 2019;59(9):690 (in Russian)].
9. Доброхотова Ю.Э., Якубова К.К. Микробиота репродуктивного тракта и гиперпластические процессы эндометрия (обзор литературы). РМЖ. Медицинское обозрение. 2018;10:14-6 [Dobrohotova YuE, Yakubova KK. Microbiota of the reproductive tract and hyperplastic processes of the endometrium (literature review). RMJ. Medical Review.
2018;10:14-6 (in Russian)].
10. Cree IA, White VA, Indave BI, Lokuhetty D. Revising the WHO classification: female genital tract tumours. Histopathology. 2020;76(1):151-6. DOI:10.1111/his.13977
11. Kurman R, Carcangiu M, Herrington C, Young R. World Health Organisation Classification of Tumors of Female Reproductive Organs, 4th edn Lyon France: International Agency for Research on Cancer (IARC) Press, 2014.
12. Pennant ME, Mehta R, Moody P, et al. Premenopausal abnormal uterine bleeding and risk of endometrial cancer. BJOG. 2017;124:404-11.
13. Raffone A, Travaglino A, Saccone G, et al. Endometrial hyperplasia and progression to cancer: which classification system stratifies the risk better? A systematic review and meta-analysis. Arch Gynecol Obstet. 2019;299(5):1233-42.
14. Sobczuk K, Sobczuk A. New classification system of endometrial hyperplasia WHO 2014 and its clinical implications. Prz Menopauzalny. 2017;16(3):107-11. DOI:10.5114/pm.2017.70589
15. Heavy menstrual bleeding: assessment and management NICE guideline [NG88] Published date: 14 March 2018. Last updated: 31 March 2020.
16. Auclair MH, Yong PJ, Salvador S, et al. Guideline No. 392-Classification and Management of Endometrial Hyperplasia. J Obstet Gynaecol Can. 2019;41(12):1789-800. DOI:10.1016/j.jogc.2019.03.025
17. Hwang WY, Suh DH, Kim K, et al. Aspiration biopsy versus dilatation and curettage for endometrial hyperplasia prior to hysterectomy. Diagn Pathol. 2021;16(1):7. DOI:10.1186/s13000-020-01065-0
18. Lee N, Lee KB, Kim K, et al. Risk of occult atypical hyperplasia or cancer in women with nonatypical endometrial hyperplasia. J Obstet Gynaecol Res. 2020. DOI:10.1111/jog.14474
19. Фэн И., Сидорова И.С., Станоевич И.В., и др. Сочетание гиперпластических процессов эндометрия с хроническим эндометритом. Акушерство, гинекология, репродукция. 2012;1(6):31-3 [Fen I, Sidorova IS, Stanoevich IV, et al. Combination of hyperplastic endometrial processes with chronic endometritis. Obstetrics, Gynecology, Reproduction. 2012;1(6):31-3 (in Russian)].
20. Rosen MW, Tasset J, Kobernik EK, et al. Risk Factors for Endometrial Cancer or Hyperplasia in Adolescents and Women 25 Years Old or Younger. J Pediatr Adolesc Gynecol. 2019;32(5):546-9. DOI:10.1016/j.jpag.2019.06.004
21. Chandra V, Kim JJ, Benbrook DM, et al. Therapeutic options for management of endometrial hyperplasia. J Gynecol Oncol. 2016;27(1):e8. DOI:10.3802/jgo.2016.27.e8
22. Овсянникова Т.В., Куликов И.А. Контрацептивные и лечебные возможности эстроген-гестагенных препаратов. Гинекология. 2017;19(2):5-8 [Ovsyannikova TV, Kulikov IA. Contraceptive and therapeutic possibilities of estrogen-progestogenic drugs. Gynecology. 2017;19(2):5-8 (in Russian)].
23. Гинекология. Национальное руководство. М.: ГЭОТАР-Медиа, 2017; c. 423-50 [Ginekologiia. Natsionalnoe rukovodstvo. Moscow: GEOTAR-Media, 2017; p. 423-50 (in Russian)].
24. Karlsson T, Johansson T, Höglund J, et al. Time-Dependent Effects of Oral Contraceptive Use on Breast, Ovarian, and Endometrial Cancers. Cancer Res. 2021;81(4):1153-62. DOI:10.1158/0008-5472.CAN-20-2476
25. Ефанова Н.А., Емельянова Т.А., Михельсон А.Ф., и др. Применение адаптированного клинико-психологического подхода к лечению пациенток с гиперплазией эндометрия в условиях поликлиники. Архив акушерства и гинекологии им. В.Ф. Снегирева. 2019;6(3):163-8 [Efanova NA, Emel'yanova TA, Mihel'son AF, et al. The use of an adapted clinical and psychological approach to the treatment of patients with endometrial hyperplasia in the polyclinic. Archive of Obstetrics and Gynecology named after VF Snegirev. 2019;6(3):163-8 (in Russian)].
26. Кузнецова И.В., Тихоновская И.В. Персонализированный подход в диагностике, лечении и профилактике гиперплазии эндометрия: современные рекомендации и клиническая практика. Женская клиника. 2021;1:67-75 [Kuznecova IV, Tihonovskaya IV. Personalized approach in the diagnosis, treatment and prevention of endometrial hyperplasia: current recommendations and clinical practice. Women's Clinic. 2021;1:67-75 (in Russian)].
27. Кузнецова И.В., Якутова М.В. Лечение менопаузальных расстройств при наличии риска гиперплазии эндометрия у женщин с избыточной массой тела. Гинекология. 2008;10(4):46-9 [Kuznecova IV, Yakutova MV. Treatment of menopausal disorders in the presence of a risk of endometrial hyperplasia in overweight women. Gynecology. 2008;10(4):46-9 (in Russian)].
28. Gierisch JM, Coeytaux RR, Urrutia RP, et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomarkers Prev. 2013;22(11):193-43.
29. Маквей Э., Джиллбоуд Д., Хамбэг Р. Репродуктивная медицина и планирование семьи. М.: МЕДпресс-информ, 2016; c. 51-275 [Makvei E, Dzhillboud D, Hambeg R. Reproduktivnaia meditsina I planirovaniie semii. Moscow: MEDpress-inform, 2016; p. 51-275 (in Russian)].
30. Mittermeier T, Farrant C, Wise MR. Levonorgestrel-releasing intrauterine system for endometrial hyperplasia. Cochrane Database Syst Rev. 2020;9:CD012658. DOI:10.1002/14651858.CD012658
31. Оrbo A, Arnes M, Vereide AB, Straume B. Relapse risk of endometrial hyperplasia after treatment with the levonorgestrel-impregnated intrauterine system or oral progestogens. BJOG. 2016;123(9):1512-9. DOI:10.1111/1471-0528.13763
32. Гаджиева Л.Т., Пронин С.М., Павлович С.В., и др. Органосохраняющее лечение атипической гиперплазии и начального рака эндометрия в репродуктивном возрасте, исходы лечения. Гинекология. 2023;25(2):177-82 [Gadzhieva LT, Pronin SM, Pavlovich SV, et al. Organ-preserving treatment of atypical hyperplasia and initial endometrial cancer in reproductive age, treatment outcomes. Gynecology. 2023;25(2):177-82 (in Russian)].
33. Henley SJ, Ward EM, Scott S, et al. Annual report to the nation on the status of Cancer, part I: national Cancer statistics. Cancer. 2020;126(10):2225-49.
34. Новикова О.В., Авасова Ч.А., Новикова Е.Г., и др. Новый вариант гормонального лечения атипической гиперплазии и начального рака эндометрия с сохранением фертильности. Онкогинекология. 2019;1(29):36-45 [Novikova OV, Avasova CHA, Novikova EG, et al. A new variant of hormonal treatment of atypical hyperplasia and initial endometrial cancer with preservation of fertility. Oncogynecology. 2019;1(29):36-45 (in Russian)].
35. Sletten ET, Arnes M, Lyså LM, et al. Significance of progesterone receptors (PR-A and PR-B) expression as predictors for relapse after successful therapy of endometrial hyperplasia: a retrospective cohort study. BJOG. 2019;126(7):936-94.
36. Andreeva E, Absatarova Y. Triptorelin for the treatment of adenomyosis: A multicenter observational study of 465 women in Russia. Int J Gynaecol Obstet. 2020;151(3):347-54. DOI:10.1002/ijgo.13341
37. Clement NS, Oliver TR, Shiwani H, et al. Metformin for endometrial hyperplasia. Cochrane Database Syst Rev. 2017;10(10):CD012214. DOI:10.1002/14651858.CD012214.pub2
38. Ильясова Н.А., Бурлев В.А. Прогнозирование исходов гистерорезектоскопической деструкции эндометрия у больных с гиперплазией эндометрия без атипии. Проблемы репродукции. 2020;26(1):18-28 [Il'yasova NA, Burlev VA. Prediction of outcomes of hysteroresectoscopic destruction of the endometrium in patients with endometrial hyperplasia without atypia. Reproduction Problems. 2020;26(1):18-28 (in Russian)].

________________________________________________

1. Endometrial hyperplasia. Clinical recommendations. 2021. Available at: https://cr.minzdrav.gov.ru/recomend/646_1. Accessed: 15.09.2023 (in Russian).
2. Kogan EA, Unanyan AL, Namiot VA, et al. A precision approach to the diagnosis and choice of tactics for the treatment of endometrial hyperplasia in perimonopause. Biophysics. 2019;4:811-20 (in Russian).
3. Sanderson PA, Critchley HO, Williams AR, et al. New concepts for an old problem: the diagnosis of endometrial hyperplasia. Hum Reprod Update. 2017;23(2):232-54. DOI:10.1093/humupd/dmw042
4. Gabidullina RI, Smirnova GA, Nuhbala FR, et al. Hyperplastic processes of the endometrium: modern management tactics of patients. Gynecology. 2019;21(6):53-8 (in Russian). DOI:10.26442/20795696.2019.6.190472 
5. Tian Y, Liu Y, Wang G, et al. Endometrial hyperplasia in infertile women undergoing IVF/ICSI: A retrospective cross-sectional study. J Gynecol Obstet Hum Reprod. 2020:101780. DOI:10.1016/j.jogoh.2020.101780
6. Hutt S, Tailor A, Ellis P, et al. The role of biomarkers in endometrial cancer and hyperplasia: a literature review. Acta Oncol. 2019;58(3):342-52. DOI:10.1080/0284186X.2018.1540886
7. Russo M, Newell JM, Budurlean L, et al. Mutational profile of endometrial hyperplasia and risk of progression to endometrioid adenocarcinoma. Cancer. 2020;126(12):2775-83. DOI:10.1002/cncr.32822
8. Marinkin IO, Lisova ES, Evchenko VV. Cellular and molecular features of endometrial hyperplasia under the influence of industrial toxic factors. Occupational Medicine and Industrial Ecology. 2019;59(9):690 (in Russian).
9. Dobrohotova YuE, Yakubova KK. Microbiota of the reproductive tract and hyperplastic processes of the endometrium (literature review). RMJ. Medical Review. 2018;10:14-6 (in Russian).
10. Cree IA, White VA, Indave BI, Lokuhetty D. Revising the WHO classification: female genital tract tumours. Histopathology. 2020;76(1):151-6. DOI:10.1111/his.13977
11. Kurman R, Carcangiu M, Herrington C, Young R. World Health Organisation Classification of Tumors of Female Reproductive Organs, 4th edn Lyon France: International Agency for Research on Cancer (IARC) Press, 2014.
12. Pennant ME, Mehta R, Moody P, et al. Premenopausal abnormal uterine bleeding and risk of endometrial cancer. BJOG. 2017;124:404-11.
13. Raffone A, Travaglino A, Saccone G, et al. Endometrial hyperplasia and progression to cancer: which classification system stratifies the risk better? A systematic review and meta-analysis. Arch Gynecol Obstet. 2019;299(5):1233-42.
14. Sobczuk K, Sobczuk A. New classification system of endometrial hyperplasia WHO 2014 and its clinical implications. Prz Menopauzalny. 2017;16(3):107-11. DOI:10.5114/pm.2017.70589
15. Heavy menstrual bleeding: assessment and management NICE guideline [NG88] Published date: 14 March 2018. Last updated: 31 March 2020.
16. Auclair MH, Yong PJ, Salvador S, et al. Guideline No. 392-Classification and Management of Endometrial Hyperplasia. J Obstet Gynaecol Can. 2019;41(12):1789-800. DOI:10.1016/j.jogc.2019.03.025
17. Hwang WY, Suh DH, Kim K, et al. Aspiration biopsy versus dilatation and curettage for endometrial hyperplasia prior to hysterectomy. Diagn Pathol. 2021;16(1):7. DOI:10.1186/s13000-020-01065-0
18. Lee N, Lee KB, Kim K, et al. Risk of occult atypical hyperplasia or cancer in women with nonatypical endometrial hyperplasia. J Obstet Gynaecol Res. 2020. DOI:10.1111/jog.14474
19. Fen I, Sidorova IS, Stanoevich IV, et al. Combination of hyperplastic endometrial processes with chronic endometritis. Obstetrics, Gynecology, Reproduction. 2012;1(6):31-3 (in Russian).
20. Rosen MW, Tasset J, Kobernik EK, et al. Risk Factors for Endometrial Cancer or Hyperplasia in Adolescents and Women 25 Years Old or Younger. J Pediatr Adolesc Gynecol. 2019;32(5):546-9. DOI:10.1016/j.jpag.2019.06.004
21. Chandra V, Kim JJ, Benbrook DM, et al. Therapeutic options for management of endometrial hyperplasia. J Gynecol Oncol. 2016;27(1):e8. DOI:10.3802/jgo.2016.27.e8
22. Ovsyannikova TV, Kulikov IA. Contraceptive and therapeutic possibilities of estrogen-progestogenic drugs. Gynecology. 2017;19(2):5-8 (in Russian).
23. Ginekologiia. Natsionalnoe rukovodstvo. Moscow: GEOTAR-Media, 2017; p. 423-50 (in Russian).
24. Karlsson T, Johansson T, Höglund J, et al. Time-Dependent Effects of Oral Contraceptive Use on Breast, Ovarian, and Endometrial Cancers. Cancer Res. 2021;81(4):1153-62. DOI:10.1158/0008-5472.CAN-20-2476
25. Efanova NA, Emel'yanova TA, Mihel'son AF, et al. The use of an adapted clinical and psychological approach to the treatment of patients with endometrial hyperplasia in the polyclinic. Archive of Obstetrics and Gynecology named after VF Snegirev. 2019;6(3):163-8 (in Russian).
26. Kuznecova IV, Tihonovskaya IV. Personalized approach in the diagnosis, treatment and prevention of endometrial hyperplasia: current recommendations and clinical practice. Women's Clinic. 2021;1:67-75 (in Russian).
27. Kuznecova IV, Yakutova MV. Treatment of menopausal disorders in the presence of a risk of endometrial hyperplasia in overweight women. Gynecology. 2008;10(4):46-9 (in Russian).
28. Gierisch JM, Coeytaux RR, Urrutia RP, et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomarkers Prev. 2013;22(11):193-43.
29. Makvei E, Dzhillboud D, Hambeg R. Reproduktivnaia meditsina I planirovaniie semii. Moscow: MEDpress-inform, 2016; p. 51-275 (in Russian).
30. Mittermeier T, Farrant C, Wise MR. Levonorgestrel-releasing intrauterine system for endometrial hyperplasia. Cochrane Database Syst Rev. 2020;9:CD012658. DOI:10.1002/14651858.CD012658
31. Оrbo A, Arnes M, Vereide AB, Straume B. Relapse risk of endometrial hyperplasia after treatment with the levonorgestrel-impregnated intrauterine system or oral progestogens. BJOG. 2016;123(9):1512-9. DOI:10.1111/1471-0528.13763
32. Gadzhieva LT, Pronin SM, Pavlovich SV, et al. Organ-preserving treatment of atypical hyperplasia and initial endometrial cancer in reproductive age, treatment outcomes. Gynecology. 2023;25(2):177-82 (in Russian).
33. Henley SJ, Ward EM, Scott S, et al. Annual report to the nation on the status of Cancer, part I: national Cancer statistics. Cancer. 2020;126(10):2225-49.
34. Novikova OV, Avasova CHA, Novikova EG, et al. A new variant of hormonal treatment of atypical hyperplasia and initial endometrial cancer with preservation of fertility. Oncogynecology. 2019;1(29):36-45 (in Russian).
35. Sletten ET, Arnes M, Lyså LM, et al. Significance of progesterone receptors (PR-A and PR-B) expression as predictors for relapse after successful therapy of endometrial hyperplasia: a retrospective cohort study. BJOG. 2019;126(7):936-94.
36. Andreeva E, Absatarova Y. Triptorelin for the treatment of adenomyosis: A multicenter observational study of 465 women in Russia. Int J Gynaecol Obstet. 2020;151(3):347-54. DOI:10.1002/ijgo.13341
37. Clement NS, Oliver TR, Shiwani H, et al. Metformin for endometrial hyperplasia. Cochrane Database Syst Rev. 2017;10(10):CD012214. DOI:10.1002/14651858.CD012214.pub2
38. Il'yasova NA, Burlev VA. Prediction of outcomes of hysteroresectoscopic destruction of the endometrium in patients with endometrial hyperplasia without atypia. Reproduction Problems. 2020;26(1):18-28 (in Russian).

А.С. Хачатрян*¹, Ю.Э. Доброхотова², И.Ю. Ильина², С.Н. Казанцев<sup>2

1</sup>Ереванский государственный медицинский университет им. Мхитара Гераци, Ереван, Армения;
²ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*aznardoc@yahoo.com

________________________________________________

Aznar S. Khachatryan*¹, Yulia E. Dobrokhotova², Irina Iu. Il'ina², Sergey N. Kazantsev<sup>2

1</sup>Mkhitar Heratsi Yerevan State University, Yerevan, Armenia;
²Pirogov Russian National Research Medical University, Moscow, Russia
*aznardoc@yahoo.com