Endometrial hyperplasia: there are more questions than answers

Abstract

Endometrial hyperplasia is a histological diagnosis. It refers to hormone-dependent diseases, which are treated with various hormonal drugs and surgical methods. At the same time, the method and timing of monitoring of the effectiveness of treatment depend on the initial morphological diagnosis.

In recent years, there have been many changes in the classification, diagnosis and treatment of this disease. So, in 2014, a new international classification was developed by the International Agency for Research on Cancer and the World Health Organization, based on the identification of atypical cells in endometrial hyperplasia with modern molecular genetics and immunohistochemical methods. According to this classification, only two categories of endometrial hyperplasia are distinguished: with and without atypia. At the same time, the introduction of this classification in Ukraine is impossible without the involvement of morphologists and the development of a unified diagnostics strategy.

The goal of the treatment of endometrial hyperplasia is the relief of symptoms (abnormal uterine bleeding, pain) and the prevention of relapses, and most importantly the timely detection of concomitant invasive endometrial cancer. During the diagnostic search for endometrial hyperplasia at any age, alertness for cancer must be present. Currently, the search for safer methods of timely detection of endometrial cancer early stages has been given great attention, but due to imperfect methods, there are still difficulties in diagnosing and predicting benign and malignant proliferative processes.

An unfavorable outcome in the inadequate management of patients with benign tumors and uterine hyperplastic processes, especially when combined, is radical surgical treatment − hysterectomy. And only the mutual work of morphologists and gynecologists, which are aware of the difficulties in diagnosis and treatment, namely the presence of resistance to certain pharmacological groups of drugs in a number of women, will not allowed to lose time and review the strategy of management for that patients for applying the reasonable methods of treatment.