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Современные подходы к диагностике и профилактике гиперплазии эндометрия
Кузнецова И.В., Ведзижева Э.Р. Современные подходы к диагностике и профилактике гиперплазии эндометрия. Гинекология. 2025;27(1):73–80. DOI: 10.26442/20795696.2025.1.203179
© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.
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Kuznetsova IV, Vedzizheva ER. Current approaches to diagnosing and preventing endometrial hyperplasia: A review. Gynecology. 2025;27(1):73–80. DOI: 10.26442/20795696.2025.1.203179
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Аннотация
Проблема гиперплазии эндометрия (ГЭ) сохраняет свою значимость на протяжении многих лет прежде всего по причине связи патологической пролиферации эндометрия с развитием злокачественной опухоли матки. Факторы риска рака эндометрия (РЭ) известны, среди них важную роль играет доброкачественная ГЭ, тогда как атипическая ГЭ относится, скорее, к прогностическим факторам развития аденокарциномы. Основным клиническим симптомом ГЭ являются аномальные маточные кровотечения, однако данный симптом не специфичен и встречается при большом числе гинекологических и негинекологических заболеваний. Во избежание ненужных инвазивных вмешательств в мире разрабатываются клинико-лабораторные критерии, которые позволяют отбирать для дальнейших диагностических манипуляций пациенток с высоким риском ГЭ/неоплазии эндометрия. В статье обсуждаются современные подходы к инструментальной диагностике и клинической оценке факторов риска у женщин в репродуктивном периоде и постменопаузе с симптомами и без симптомов маточных кровотечений. Лечение ГЭ, особенно при наличии клеточной атипии, достаточно сложно и не всегда эффективно, поэтому профилактика ГЭ и РЭ представляется лучшим стратегическим выбором. С этой целью могут использоваться комбинированные оральные контрацептивы, канцеропротективный потенциал которых хорошо известен. Приводятся варианты выбора комбинированных оральных контрацептивов, наиболее подходящих для контрацепции у женщин с риском ГЭ и РЭ.
Ключевые слова: гиперплазия эндометрия, рак эндометрия, аномальные маточные кровотечения, постменопаузальные кровотечения, факторы риска, комбинированные оральные контрацептивы, прогестины
Ключевые слова: гиперплазия эндометрия, рак эндометрия, аномальные маточные кровотечения, постменопаузальные кровотечения, факторы риска, комбинированные оральные контрацептивы, прогестины
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The problem of endometrial hyperplasia (EH) has been relevant for many years, primarily due to the association of abnormal endometrial proliferation with uterus malignancies. Endometrial cancer (EC) risk factors are known, with benign EH being one of the most important, while atypical EH is more likely to be a prognostic factor for the development of adenocarcinoma. The main clinical symptom of EH is abnormal uterine bleeding, but this symptom is not specific and occurs in many gynecological and non-gynecological conditions. In order to avoid unnecessary invasive interventions, clinical and laboratory criteria are being developed for selecting patients with a high risk of EH/endometrial neoplasia and for further diagnostic manipulations. The article discusses modern approaches to instrumental diagnosis and clinical assessment of risk factors in women of reproductive age and the postmenopausal period with and without symptoms of uterine bleeding. Treatment of EH, especially in the presence of cellular atypia, is challenging and not consistently effective, so prevention of EH and EC is the best strategic choice. For this purpose, combined oral contraceptives can be used due to their well-known carcinoprotective potential. The options for the choice of combined oral contraceptives most suitable for contraception in women at risk of EH and EC are given.
Keywords: endometrial hyperplasia, endometrial cancer, abnormal uterine bleeding, postmenopausal bleeding, risk factors, combined oral contraceptives, progestins
Полный текст
Список литературы
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5. Shen Y, Yang W, Liu J, Zhang Y. Minimally invasive approaches for the early detection of endometrial cancer. Mol Cancer. 2023;22(1):53. DOI:10.1186/s12943-023-01757-3
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9. Xue H, Shen WJ, Zhang Y. Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometrium. World J Clin Cases. 2022;10(7):2159-15. DOI:10.12998/wjcc.v10.i7.2159
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12. Petersdorf K, Groettrup-Wolfers E, Overton PM, et al. Endometrial hyperplasia in pre-menopausal women: A systematic review of incidence, prevalence, and risk factors. Eur J Obstet Gynecol Reprod Biol. 2022;271:158-71. DOI:10.1016/j.ejogrb.2022.02.015
13. Zhao J, Hu Y, Zhao Y, et al. Risk factors of endometrial cancer in patients with endometrial hyperplasia: implication for clinical treatments. BMC Womens Health. 2021;21(1):312. DOI:10.1186/s12905-021-01452-9
14. Nees LK, Heublein S, Steinmacher S, et al. Endometrial hyperplasia as a risk factor of endometrial cancer. Arch Gynecol Obstet. 2022;306(2):407-21. DOI:10.1007/s00404-021-06380-5
15. Doherty MT, Sanni OB, Coleman HG, et al. Concurrent and future risk of endometrial cancer in women with endometrial hyperplasia: A systematic review and meta-analysis. PLoS One. 2020;15(4):e0232231. DOI:10.1371/journal.pone.0232231
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18. Murugappan G, Li S, Lathi RB, et al. Risk of cancer in infertile women: analysis of US claims data. Hum Reprod. 2019;34(5):894-902. DOI:10.1093/humrep/dez018
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20. Harris HR, Terry KL. Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: a systematic review. Fertil Res Pract. 2016;2:14. DOI:10.1186/s40738-016-0029-2
21. Coelingh Bennink HJT, van Gennip FAM, Gerrits MGF, et al. Health benefits of combined oral contraceptives – a narrative review. Eur J Contracept Reprod Health Care. 2024;29(2):40-52. DOI:10.1080/13625187.2024.2317295
22. Heremans R, Wynants L, Valentin L, et al. Estimating risk of endometrial malignancy and other intracavitary uterine pathology in women without abnormal uterine bleeding using IETA-1 multinomial regression model: validation study. Ultrasound Obstet Gynecol. 2024;63(4):556-63. DOI:10.1002/uog.27530
23. Epstein E, Fischerova D, Valentin L, et al. Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study. Ultrasound Obstet Gynecol. 2018;51(6):818-28. DOI:10.1002/uog.18909
24. Stachowicz N, Smoleń A, Ciebiera M, et al. Risk Assessment of Endometrial Hyperplasia or Endometrial Cancer with Simplified Ultrasound-Based Scoring Systems. Diagnostics (Basel). 2021;11(3):442. DOI:10.3390/diagnostics11030442
25. Jiang T, Yuan Q, Zhou Q, et al. Do endometrial lesions require removal? A retrospective study. BMC Womens Health. 2019;19(1):61. DOI:10.1186/s12905-019-0756-8
26. Giri SK, Nayak BL, Mohapatra J. Thickened Endometrium: When to Intervene? A Clinical Conundrum. J Obstet Gynaecol India. 2021;71(3):216-25. DOI:10.1007/s13224-020-01415-4
27. Fischerova D, Cibula D. Ultrasound in gynecological cancer: is it time for re-evaluation of its uses? Curr Oncol Rep. 2015;17(6):28. DOI:10.1007/s11912-015-0449-x
28. Park YR, Lee SW, Kim Y, et al. Endometrial thickness cut-off value by transvaginal ultrasonography for screening of endometrial pathology in premenopausal and postmenopausal women. Obstet Gynecol Sci. 2019;62(6):445-53. DOI:10.5468/ogs.2019.62.6.445
29. Saccardi C, Spagnol G, Bonaldo G, et al. New Light on Endometrial Thickness as a Risk Factor of Cancer: What Do Clinicians Need to Know? Cancer Manag Res. 2022;14:1331-30. DOI:10.2147/CMAR.S294074
30. Kim MJ, Kim JJ, Kim SM. Endometrial evaluation with transvaginal ultrasonography for the screening of endometrial hyperplasia or cancer in premenopausal and perimenopausal women. Obstet Gynecol Sci. 2016;59(3):192-200. DOI:10.5468/ogs.2016.59.3.192
31. Nasheeha N, Gk P. Diagnostic accuracy of uterine artery and spiral artery Doppler for evaluation of endometrial pathology in postmenopausal bleeding. J Gynecol Obstet Hum Reprod. 2021;50(10):102209. DOI:10.1016/j.jogoh.2021.102209
32. Doll KM, Romano SS, Marsh EE, Robinson WR. Estimated Performance of Transvaginal Ultrasonography for Evaluation of Postmenopausal Bleeding in a Simulated Cohort of Black and White Women in the US. JAMA Oncol. 2021;7(8):1158-15. DOI:10.1001/jamaoncol.2021.1700
33. Long B, Clarke MA, Morillo ADM, et al. Ultrasound detection of endometrial cancer in women with postmenopausal bleeding: Systematic review and meta-analysis. Gynecol Oncol. 2020;157(3):624-33. DOI:10.1016/j.ygyno.2020.01.032
34. ACOG Committee Opinion No. 734: The Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Women With Postmenopausal Bleeding. Obstet Gynecol. 2018;131(5):e124-19. DOI:10.1097/AOG.0000000000002631
35. Wong AS, Lao TT, Cheung CW, et al. Reappraisal of endometrial thickness for the detection of endometrial cancer in postmenopausal bleeding: a retrospective cohort study. BJOG. 2016;123(3):439-46. DOI:10.1111/1471-0528.13342
36. Sladkevicius P, Installé A, Van Den Bosch T, et al. International Endometrial Tumor Analysis (IETA) terminology in women with postmenopausal bleeding and sonographic endometrial thickness ≥ 4.5 mm: agreement and reliability study. Ultrasound Obstet Gynecol. 2018;51(2):259-68. DOI:10.1002/uog.18813
37. Wolfman W. No. 249-Asymptomatic Endometrial Thickening. J Obstet Gynaecol Can. 2018;40(5):e367-77. DOI:10.1016/j.jogc.2018.03.005
38. Parkash V, Fadare O, Tornos C, McCluggage WG. Committee Opinion No. 631: Endometrial Intraepithelial Neoplasia. Obstet Gynecol. 2015;126(4):897. DOI:10.1097/AOG.0000000000001071
39. Clark TJ, Stevenson H. Endometrial Polyps and Abnormal Uterine Bleeding (AUB-P): What is the relationship, how are they diagnosed and how are they treated? Best Pract Res Clin Obstet Gynaecol. 2017;40:89-104. DOI:10.1016/j.bpobgyn.2016.09.005
40. Vroom AJ, Timmermans A, Bongers MY, et al. Diagnostic accuracy of saline contrast sonohysterography in detecting endometrial polyps in women with postmenopausal bleeding: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2019;54(1):28-34. DOI:10.1002/uog.20229
41. D'Angelo E, Espinosa I, Cipriani V, et al. Atypical Endometrial Hyperplasia, Low-grade: “Much ADO About Nothing”. Am J Surg Pathol. 2021;45(7):988-96. DOI:10.1097/PAS.0000000000001705
42. Loffer FD. The Time Has Come to Quit Relying on a Blind Endometrial Biopsy or Dilation and Curettage to Rule Out Malignant Endometrial Changes. J Minim Invasive Gynecol. 2019;26(7):1207-28. DOI:10.1016/j.jmig.2019.04.011
43. Deeba F, Shaista H, Khan B. Histological Pattern Of Endometrial Samples In Postmenopausal Women With Abnormal Uterine Bleeding. J Ayub Med Coll Abbottabad. 2016;28(4):721-2.
44. De Franciscis P, Riemma G, Schiattarella A, et al. Concordance between the Hysteroscopic Diagnosis of Endometrial Hyperplasia and Histopathological Examination. Diagnostics (Basel). 2019;9(4):142. DOI:10.3390/diagnostics9040142
45. Breijer MC, van Hanegem N, Visser NC, et al. Does probability guided hysteroscopy reduce costs in women investigated for postmenopausal bleeding? ScientificWorldJournal. 2015;2015:605312. DOI:10.1155/2015/605312
46. Tehranian A, Bayani L, Heidary S, et al. Diagnostic accuracy of sonohysterography compared to endometrial biopsy in pre-menopausal women with abnormal uterine bleeding. Med J Islam Repub Iran. 2015;29:201.
47. Viveros-Carreño D, Mora-Soto N, Pareja R. Value of sentinel node ultrastaging and pathologic techniques in tumoral detection. Curr Opin Oncol. 2024;36(5):376-82. DOI:10.1097/CCO.0000000000001061
48. Topçu HO, Kaya C, Oral E. Fertility issue in early stage endometrial cancer patients. Transl Cancer Res. 2020;9(12):7797-808. DOI:10.21037/tcr-20-2232
49. 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
50. Zaino R, Carinelli SG, Ellenson LH, et al. Tumours of the uterine Corpus: epithelial Tumours and Precursors. In: Kurman RJ, Carcanglu ML, Herrington CS, Young RH, eds. WHO Classification of Tumours of female reproductive Organs. 4th ed. Lyon: WHO Press, 2014;125-6.
51. Antonsen SL, Ulrich L, Høgdall C. Patients with atypical hyperplasia of the endometrium should be treated in oncological centers. Gynecol Oncol. 2012;125(1):124-8. DOI: 10.1016/j.ygyno.2011.12.436
52. Travaglino A, Raffone A, Saccone G, et al. Complexity of glandular architecture should be reconsidered in the classification and management of endometrial hyperplasia. APMIS. 2019;127(6):427-34. DOI:10.1111/apm.12945
53. Iversen ML, Dueholm M. Complex non atypical hyperplasia and the subsequent risk of carcinoma, atypia and hysterectomy during the following 9–14 years. Eur J Obstet Gynecol Reprod Biol. 2018;222:171-7. DOI:10.1016/j.ejogrb.2018.01.026
54. Auclair MH, Yong PJ, Salvador S, et al. Guideline No. 390-Classification and Management of Endometrial Hyperplasia. J Obstet Gynaecol Can. 2019;41(12):1789-800. DOI:10.1016/j.jogc.2019.03.025
55. Stanczyk FZ, Archer DF. Gestodene: a review of its pharmacology, potency and tolerability in combined contraceptive preparations. Contraception. 2014;89(4):242-52. DOI:10.1016/j.contraception.2013.12.003
56. Bick AJ, Louw-du Toit R, Skosana SB, et al. Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception. Pharmacol Ther. 2021;222:107789. DOI:10.1016/j.pharmthera.2020.107789
57. 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 tactics of patient management. Gynecology. 2019;21(6):53-8 (in Russian)]. DOI:10.26442/20795696.2019.6.190472
58. Fortner RT, Hüsing A, Dossus L, et al. Theoretical potential for endometrial cancer prevention through primary risk factor modification: Estimates from the EPIC cohort. Int J Cancer. 2020;147(5):1325-33. DOI:10.1002/ijc.32901
59. Michels KA, Pfeiffer RM, Brinton LA, Trabert B. Modification of the Associations Between Duration of Oral Contraceptive Use and Ovarian, Endometrial, Breast, and Colorectal Cancers. JAMA Oncol. 2018;4(4):516-21. DOI:10.1001/jamaoncol.2017.4942
60. Filomeno M, Bosetti C, Bidoli E, et al. Mediterranean diet and risk of endometrial cancer: a pooled analysis of three Italian case-control studies. Br J Cancer. 2015;112(11):1816-21. DOI:10.1038/bjc.2015.153
61. Wilson RB, Lathigara D, Kaushal D. Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on Future Cancer Risk. Int J Mol Sci. 2023;24(7):6192. DOI:10.3390/ijms24076192
________________________________________________
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2. Contreras NA, Sabadell J, Verdaguer P, et al. Fertility-Sparing Approaches in Atypical Endometrial Hyperplasia and Endometrial Cancer Patients: Current Evidence and Future Directions. Int J Mol Sci. 2022;23(5):2531. DOI:10.3390/ijms23052531
3. Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941-93. DOI:10.1002/ijc.31937
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6. Pennant ME, Mehta R, Moody P, et al. Premenopausal abnormal uterine bleeding and risk of endometrial cancer. BJOG. 2017;124(3):404-11. DOI:10.1111/1471-0528.14385
7. Ponomarenko IV, Polonikov AV, Churnosov MI. Endometrial hyperplastic processes: etiopathogenesis, risk factors, polymorphism of candidate genes. Obstetrics and Gynecology. 2019;1:13-8 (in Russian). DOI:10.18565/aig.2019.1.13-18
8. van Hanegem N, Breijer MC, Slockers SA, et al. Diagnostic workup for postmenopausal bleeding: a randomised controlled trial. BJOG. 2017;124(2):231-40. DOI:10.1111/1471-0528.14126
9. Xue H, Shen WJ, Zhang Y. Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometrium. World J Clin Cases. 2022;10(7):2159-15. DOI:10.12998/wjcc.v10.i7.2159
10. Bel S, Billard C, Godet J, et al. Risk of malignancy on suspicion of polyps in menopausal women. Eur J Obstet Gynecol Reprod Biol. 2017;216:138-42. DOI:10.1016/j.ejogrb.2017.07.013
11. Ignatov A, Ortmann O. Endocrine Risk Factors of Endometrial Cancer: Polycystic Ovary Syndrome, Oral Contraceptives, Infertility, Tamoxifen. Cancers (Basel). 2020;12(7):1766. DOI:10.3390/cancers12071766
12. Petersdorf K, Groettrup-Wolfers E, Overton PM, et al. Endometrial hyperplasia in pre-menopausal women: A systematic review of incidence, prevalence, and risk factors. Eur J Obstet Gynecol Reprod Biol. 2022;271:158-71. DOI:10.1016/j.ejogrb.2022.02.015
13. Zhao J, Hu Y, Zhao Y, et al. Risk factors of endometrial cancer in patients with endometrial hyperplasia: implication for clinical treatments. BMC Womens Health. 2021;21(1):312. DOI:10.1186/s12905-021-01452-9
14. Nees LK, Heublein S, Steinmacher S, et al. Endometrial hyperplasia as a risk factor of endometrial cancer. Arch Gynecol Obstet. 2022;306(2):407-21. DOI:10.1007/s00404-021-06380-5
15. Doherty MT, Sanni OB, Coleman HG, et al. Concurrent and future risk of endometrial cancer in women with endometrial hyperplasia: A systematic review and meta-analysis. PLoS One. 2020;15(4):e0232231. DOI:10.1371/journal.pone.0232231
16. Verbakel JY, Heremans R, Wynants L, et al. Risk assessment for endometrial cancer in women with abnormal vaginal bleeding: Results from the prospective IETA-1 cohort study. Int J Gynaecol Obstet. 2022;159(1):103-10. DOI:10.1002/ijgo.14097
17. Lucas E, Chen H, Molberg K, et al. Mismatch Repair Protein Expression in Endometrioid Intraepithelial Neoplasia/Atypical Hyperplasia: Should We Screen for Lynch Syndrome in Precancerous Lesions? Int J Gynecol Pathol. 2019;38(6):533-42. DOI:10.1097/PGP.0000000000000557
18. Murugappan G, Li S, Lathi RB, et al. Risk of cancer in infertile women: analysis of US claims data. Hum Reprod. 2019;34(5):894-902. DOI:10.1093/humrep/dez018
19. Amiri M, Bidhendi-Yarandi R, Fallahzadeh A, et al. Risk of endometrial, ovarian, and breast cancers in women with polycystic ovary syndrome: A systematic review and meta-analysis. Int J Reprod Biomed. 2022;20(11):893-914. DOI:10.18502/ijrm.v20i11.12357
20. Harris HR, Terry KL. Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: a systematic review. Fertil Res Pract. 2016;2:14. DOI:10.1186/s40738-016-0029-2
21. Coelingh Bennink HJT, van Gennip FAM, Gerrits MGF, et al. Health benefits of combined oral contraceptives – a narrative review. Eur J Contracept Reprod Health Care. 2024;29(2):40-52. DOI:10.1080/13625187.2024.2317295
22. Heremans R, Wynants L, Valentin L, et al. Estimating risk of endometrial malignancy and other intracavitary uterine pathology in women without abnormal uterine bleeding using IETA-1 multinomial regression model: validation study. Ultrasound Obstet Gynecol. 2024;63(4):556-63. DOI:10.1002/uog.27530
23. Epstein E, Fischerova D, Valentin L, et al. Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study. Ultrasound Obstet Gynecol. 2018;51(6):818-28. DOI:10.1002/uog.18909
24. Stachowicz N, Smoleń A, Ciebiera M, et al. Risk Assessment of Endometrial Hyperplasia or Endometrial Cancer with Simplified Ultrasound-Based Scoring Systems. Diagnostics (Basel). 2021;11(3):442. DOI:10.3390/diagnostics11030442
25. Jiang T, Yuan Q, Zhou Q, et al. Do endometrial lesions require removal? A retrospective study. BMC Womens Health. 2019;19(1):61. DOI:10.1186/s12905-019-0756-8
26. Giri SK, Nayak BL, Mohapatra J. Thickened Endometrium: When to Intervene? A Clinical Conundrum. J Obstet Gynaecol India. 2021;71(3):216-25. DOI:10.1007/s13224-020-01415-4
27. Fischerova D, Cibula D. Ultrasound in gynecological cancer: is it time for re-evaluation of its uses? Curr Oncol Rep. 2015;17(6):28. DOI:10.1007/s11912-015-0449-x
28. Park YR, Lee SW, Kim Y, et al. Endometrial thickness cut-off value by transvaginal ultrasonography for screening of endometrial pathology in premenopausal and postmenopausal women. Obstet Gynecol Sci. 2019;62(6):445-53. DOI:10.5468/ogs.2019.62.6.445
29. Saccardi C, Spagnol G, Bonaldo G, et al. New Light on Endometrial Thickness as a Risk Factor of Cancer: What Do Clinicians Need to Know? Cancer Manag Res. 2022;14:1331-30. DOI:10.2147/CMAR.S294074
30. Kim MJ, Kim JJ, Kim SM. Endometrial evaluation with transvaginal ultrasonography for the screening of endometrial hyperplasia or cancer in premenopausal and perimenopausal women. Obstet Gynecol Sci. 2016;59(3):192-200. DOI:10.5468/ogs.2016.59.3.192
31. Nasheeha N, Gk P. Diagnostic accuracy of uterine artery and spiral artery Doppler for evaluation of endometrial pathology in postmenopausal bleeding. J Gynecol Obstet Hum Reprod. 2021;50(10):102209. DOI:10.1016/j.jogoh.2021.102209
32. Doll KM, Romano SS, Marsh EE, Robinson WR. Estimated Performance of Transvaginal Ultrasonography for Evaluation of Postmenopausal Bleeding in a Simulated Cohort of Black and White Women in the US. JAMA Oncol. 2021;7(8):1158-15. DOI:10.1001/jamaoncol.2021.1700
33. Long B, Clarke MA, Morillo ADM, et al. Ultrasound detection of endometrial cancer in women with postmenopausal bleeding: Systematic review and meta-analysis. Gynecol Oncol. 2020;157(3):624-33. DOI:10.1016/j.ygyno.2020.01.032
34. ACOG Committee Opinion No. 734: The Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Women With Postmenopausal Bleeding. Obstet Gynecol. 2018;131(5):e124-19. DOI:10.1097/AOG.0000000000002631
35. Wong AS, Lao TT, Cheung CW, et al. Reappraisal of endometrial thickness for the detection of endometrial cancer in postmenopausal bleeding: a retrospective cohort study. BJOG. 2016;123(3):439-46. DOI:10.1111/1471-0528.13342
36. Sladkevicius P, Installé A, Van Den Bosch T, et al. International Endometrial Tumor Analysis (IETA) terminology in women with postmenopausal bleeding and sonographic endometrial thickness ≥ 4.5 mm: agreement and reliability study. Ultrasound Obstet Gynecol. 2018;51(2):259-68. DOI:10.1002/uog.18813
37. Wolfman W. No. 249-Asymptomatic Endometrial Thickening. J Obstet Gynaecol Can. 2018;40(5):e367-77. DOI:10.1016/j.jogc.2018.03.005
38. Parkash V, Fadare O, Tornos C, McCluggage WG. Committee Opinion No. 631: Endometrial Intraepithelial Neoplasia. Obstet Gynecol. 2015;126(4):897. DOI:10.1097/AOG.0000000000001071
39. Clark TJ, Stevenson H. Endometrial Polyps and Abnormal Uterine Bleeding (AUB-P): What is the relationship, how are they diagnosed and how are they treated? Best Pract Res Clin Obstet Gynaecol. 2017;40:89-104. DOI:10.1016/j.bpobgyn.2016.09.005
40. Vroom AJ, Timmermans A, Bongers MY, et al. Diagnostic accuracy of saline contrast sonohysterography in detecting endometrial polyps in women with postmenopausal bleeding: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2019;54(1):28-34. DOI:10.1002/uog.20229
41. D'Angelo E, Espinosa I, Cipriani V, et al. Atypical Endometrial Hyperplasia, Low-grade: “Much ADO About Nothing”. Am J Surg Pathol. 2021;45(7):988-96. DOI:10.1097/PAS.0000000000001705
42. Loffer FD. The Time Has Come to Quit Relying on a Blind Endometrial Biopsy or Dilation and Curettage to Rule Out Malignant Endometrial Changes. J Minim Invasive Gynecol. 2019;26(7):1207-28. DOI:10.1016/j.jmig.2019.04.011
43. Deeba F, Shaista H, Khan B. Histological Pattern Of Endometrial Samples In Postmenopausal Women With Abnormal Uterine Bleeding. J Ayub Med Coll Abbottabad. 2016;28(4):721-2.
44. De Franciscis P, Riemma G, Schiattarella A, et al. Concordance between the Hysteroscopic Diagnosis of Endometrial Hyperplasia and Histopathological Examination. Diagnostics (Basel). 2019;9(4):142. DOI:10.3390/diagnostics9040142
45. Breijer MC, van Hanegem N, Visser NC, et al. Does probability guided hysteroscopy reduce costs in women investigated for postmenopausal bleeding? ScientificWorldJournal. 2015;2015:605312. DOI:10.1155/2015/605312
46. Tehranian A, Bayani L, Heidary S, et al. Diagnostic accuracy of sonohysterography compared to endometrial biopsy in pre-menopausal women with abnormal uterine bleeding. Med J Islam Repub Iran. 2015;29:201.
47. Viveros-Carreño D, Mora-Soto N, Pareja R. Value of sentinel node ultrastaging and pathologic techniques in tumoral detection. Curr Opin Oncol. 2024;36(5):376-82. DOI:10.1097/CCO.0000000000001061
48. Topçu HO, Kaya C, Oral E. Fertility issue in early stage endometrial cancer patients. Transl Cancer Res. 2020;9(12):7797-808. DOI:10.21037/tcr-20-2232
49. 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
50. Zaino R, Carinelli SG, Ellenson LH, et al. Tumours of the uterine Corpus: epithelial Tumours and Precursors. In: Kurman RJ, Carcanglu ML, Herrington CS, Young RH, eds. WHO Classification of Tumours of female reproductive Organs. 4th ed. Lyon: WHO Press, 2014;125-6.
51. Antonsen SL, Ulrich L, Høgdall C. Patients with atypical hyperplasia of the endometrium should be treated in oncological centers. Gynecol Oncol. 2012;125(1):124-8. DOI: 10.1016/j.ygyno.2011.12.436
52. Travaglino A, Raffone A, Saccone G, et al. Complexity of glandular architecture should be reconsidered in the classification and management of endometrial hyperplasia. APMIS. 2019;127(6):427-34. DOI:10.1111/apm.12945
53. Iversen ML, Dueholm M. Complex non atypical hyperplasia and the subsequent risk of carcinoma, atypia and hysterectomy during the following 9–14 years. Eur J Obstet Gynecol Reprod Biol. 2018;222:171-7. DOI:10.1016/j.ejogrb.2018.01.026
54. Auclair MH, Yong PJ, Salvador S, et al. Guideline No. 390-Classification and Management of Endometrial Hyperplasia. J Obstet Gynaecol Can. 2019;41(12):1789-800. DOI:10.1016/j.jogc.2019.03.025
55. Stanczyk FZ, Archer DF. Gestodene: a review of its pharmacology, potency and tolerability in combined contraceptive preparations. Contraception. 2014;89(4):242-52. DOI:10.1016/j.contraception.2013.12.003
56. Bick AJ, Louw-du Toit R, Skosana SB, et al. Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception. Pharmacol Ther. 2021;222:107789. DOI:10.1016/j.pharmthera.2020.107789
57. Gabidullina RI, Smirnova GA, Nuhbala FR, et al. Hyperplastic processes of the endometrium: modern tactics of patient management. Gynecology. 2019;21(6):53-8 (in Russian). DOI:10.26442/20795696.2019.6.190472
58. Fortner RT, Hüsing A, Dossus L, et al. Theoretical potential for endometrial cancer prevention through primary risk factor modification: Estimates from the EPIC cohort. Int J Cancer. 2020;147(5):1325-33. DOI:10.1002/ijc.32901
59. Michels KA, Pfeiffer RM, Brinton LA, Trabert B. Modification of the Associations Between Duration of Oral Contraceptive Use and Ovarian, Endometrial, Breast, and Colorectal Cancers. JAMA Oncol. 2018;4(4):516-21. DOI:10.1001/jamaoncol.2017.4942
60. Filomeno M, Bosetti C, Bidoli E, et al. Mediterranean diet and risk of endometrial cancer: a pooled analysis of three Italian case-control studies. Br J Cancer. 2015;112(11):1816-21. DOI:10.1038/bjc.2015.153
61. Wilson RB, Lathigara D, Kaushal D. Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on Future Cancer Risk. Int J Mol Sci. 2023;24(7):6192. DOI:10.3390/ijms24076192
Авторы
И.В. Кузнецова*1, Э.Р. Ведзижева2
1ООО «Витбиомед+», Москва, Россия;
2ГБУЗ «Городская клиническая больница им. Д.Д. Плетнева» Департамента здравоохранения г. Москвы, Москва, Россия
*ms.smith.ivk@gmail.com
1ООО «Витбиомед+», Москва, Россия;
2ГБУЗ «Городская клиническая больница им. Д.Д. Плетнева» Департамента здравоохранения г. Москвы, Москва, Россия
*ms.smith.ivk@gmail.com
________________________________________________
Irina V. Kuznetsova*1, Elina R. Vedzizheva2
1Vitbiomed+ LLC, Moscow, Russia;
2Pletnev City Clinical Hospital, Moscow, Russia
*ms.smith.ivk@gmail.com
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.