RESUMEN
OBJECTIVE: The aim of the study was to systematically review studies that evaluated endometrial hyperplasia or cancer incidence with unopposed vaginal estrogens. METHODS: PubMed and EMBASE were searched from inception to August 2017 for relevant articles and abstracts. Bibliographies of review articles and abstracts of major women's health medical meetings were examined. Eligible studies (independently reviewed by 4 authors) had to report menopausal vaginal estrogen use and endometrial histology, or incidence of endometrial hyperplasia or cancer. RESULTS: Of 5,593 abstracts from the literature search and 47 articles from other sources, 36 articles and 2 abstracts were eligible, describing 20 randomized controlled studies, 8 interventional studies, and 10 observational studies. Collectively, the studies did not support an increased risk of endometrial hyperplasia or cancer with low-dose vaginal estrogens. Rates of endometrial cancer and hyperplasia were 0.03% and 0.4%, respectively, from 20 randomized controlled trials (2,983 women) of vaginal estrogens. Overall, reports of endometrial hyperplasia were observed with various doses and durations and appeared sporadic (except 1.25âmg conjugated equine estrogens), consistent with endometrial hyperplasia rates in the general population. A Denmark registry study was an exception and may be of limited applicability to the United States. The Women's Health Initiative Observational Study showed no association (1.3 cases/1,000 women-years with vaginal estrogens versus 1.0/1,000 women-years for nonuse). CONCLUSION: This systematic review supports the use of low-dose vaginal estrogens for treating vulvar and vaginal atrophy in menopausal women without a concomitant progestogen. This review does not support increased endometrial hyperplasia or cancer risk with low-dose, unopposed vaginal estrogens; however, longer-term, real-world data are needed.
Asunto(s)
Hiperplasia Endometrial/epidemiología , Estrógenos/administración & dosificación , Estrógenos/efectos adversos , Medicina Basada en la Evidencia , Menopausia , Administración Intravaginal , Relación Dosis-Respuesta a Droga , Estrógenos Conjugados (USP)/administración & dosificación , Femenino , Humanos , Estudios Observacionales como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Estados Unidos/epidemiología , Salud de la MujerRESUMEN
OBJECTIVES: To assess the risk of endometrial cancer (EC) associated with atypical glandular cells of endometrial origin (AGC-EM) in 2 age groups (age younger than 51 vs 51 years or older). METHODS: A retrospective case series was assembled identifying AGC from a pathology database between January 1, 2005 and January 1, 2009. Demographics, cervical cytology results, and final diagnoses (including clinically significant diseases and cancers) were recorded from the initial AGC diagnosis until August 30, 2011. Data were analyzed using the χ test to compare rates of disease between age groups. RESULTS: Among the 444 patients with AGC, 41% (183/444) had AGC-EM. Women younger than 51 years, compared to those 51 years or older, had significantly lower rates of AGC-EM (35% [105/296] vs 53% [78/148]; p < .001; odds ratio, 0.49; 95% confidence interval, 0.33-0.74). The rate of EC was significantly lower in those younger than 51 years, compared to those aged 51 or older (5% [8/158] vs 19% [18/95]; p < .001; odds ratio, 0.23; 95% confidence interval, 0.09-0.55) in women who underwent endometrial biopsy. In women younger than 51 years who underwent an endometrial biopsy, the rate of EC had a stepwise increase across 3 subclasses of AGC (from AGC of endocervical origin [AGC-EC] to AGC not otherwise specified to AGC-EM) (p = .04). CONCLUSIONS: Women aged 51 years or older who have AGC are more likely to have AGC-EM and EC than women younger than 51 years. In women younger than age 51, AGC-EM is the subclass most associated with EC while compared to 2 other subclasses (AGC not otherwise specified and AGC-EC).
Asunto(s)
Hiperplasia Endometrial/epidemiología , Neoplasias Endometriales/epidemiología , Adulto , Distribución por Edad , Anciano , Bases de Datos Factuales , Hiperplasia Endometrial/patología , Neoplasias Endometriales/patología , Endometrio/patología , Femenino , Humanos , Persona de Mediana Edad , Pennsylvania/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Salud de la MujerRESUMEN
OBJECTIVE: To assess adherence to management guidelines based on the terminology used to describe atypical glandular cells (AGC) on cytology reports. MATERIALS AND METHODS: We analyzed AGC pathology reports from Hartford Hospital, 2004-2007, and identified cases of AGC with the terminology atypical glandular cells or atypical endocervical cells (AEC). We calculated rates of clinical evaluations based on the terminology used to describe the AGC. Statistical analysis was performed using the χ test. RESULTS: Seventy-eight reports contained the terminology AEC and 97 reports contained the terminology AGC. The rate of histologic sampling in women with AEC was lower than in women with AGC (52.6% vs 83.5%; p < .01). Similarly, the rate of comprehensive evaluations was lower (33.3% vs 71.1%; p < .01). Fewer endocervical curettages (47.4% vs 77.3%; p < .01) and fewer endometrial biopsies in women 35 years or older were performed (26.9% vs 69.1%; p < .01) in women with AEC than in women with AGC. CONCLUSIONS: Women with AGC reports containing the term AEC were managed less optimally than those with AGC. These results suggest that the terminology used to describe the finding of atypical glandular cells may influence the clinical evaluation. Clinicians may not recognize AEC as AGCs. Ours results suggest that the terminology atypical endocervical cells should be avoided or accompanied by the terminology atypical glandular cells.
Asunto(s)
Hiperplasia Endometrial/clasificación , Hiperplasia Endometrial/patología , Terminología como Asunto , Displasia del Cuello del Útero/clasificación , Displasia del Cuello del Útero/patología , Adulto , Cuello del Útero/patología , Colposcopía , Legrado , Bases de Datos Factuales , Hiperplasia Endometrial/epidemiología , Hiperplasia Endometrial/cirugía , Femenino , Adhesión a Directriz , Humanos , Persona de Mediana Edad , Neoplasias del Cuello Uterino/clasificación , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/patología , Salud de la Mujer , Displasia del Cuello del Útero/epidemiologíaRESUMEN
Introducción: la hiperplasia endometrial es la proliferación de las glándulas endometriales en tamaño y forma irregular, causada por una excesiva exposición a los estrógenos.Objetivo: caracterizar las hiperplasias endometriales en pacientes del Hospital Eusebio Hernández durante todo el año 2011.Método: se realizó un estudio observacional descriptivo. Se revisaron 2 842 informes histopatológicos en el Departamento de Patología del Hospital Ginecobstétrico Profesor Eusebio Hernández en Marianao, La Habana en el periodo comprendido entre el 1º de enero y el 31 de diciembre de 2011, de los cuales 1 269 correspondieron a biopsias de endometrio obtenidas por legrado.Resultados: en 154 de las biopsias endometriales (12,1 por ciento) el diagnóstico fue de hiperplasia endometrial. El rango de edades de mayor frecuencia de diagnóstico fue el de las mujeres entre 41 y 50 años y en el mayor porcentaje de pacientes (84,4 por ciento) se diagnosticó hiperplasia simple sin atipias; mientras que, el 7,1 por ciento de los casos presentó atipias. El factor de riesgo más asociado fue la obesidad en 46,1 por ciento de los casos. El ultrasonido tuvo una positividad en los casos con atipia endometrial del 90,9 por ciento y la histeroscopia del 100 por ciento. El tratamiento hormonal fue utilizado en el 67,5 por ciento de las pacientes y el tratamiento quirúrgico se utilizó en la totalidad de las pacientes con atipias celulares.Conclusiones: hubo predominio de hiperplasia endometrial sin atipia en las mujeres con edades entre 41 y 60 años y con menor paridad y una baja...
Introduction: endometrial hyperplasia is a proliferation of endometrial glands in size and irregular shape, caused by excessive exposure to estrogen. Objective: to characterize the endometrial hyperplasia in patients at Eusebio Hernández Hospital in 2011. Method: a descriptive study was conducted. 2842 pathology reports were reviewed in the Department of Pathology, at Profesor Eusebio Hernández Gynecobstetric Hospital in Marianao, Havana from January 1st to December 31st, 2011. 1269 of them were for endometrial biopsies obtained by curettage. Results: 154 endometrial biopsies (12.1 percent) had the diagnosis of endometrial hyperplasia. The age range of diagnosis was more frequent for women between 41 and 50 years and the highest percentage of patients (84.4 percent) were diagnosed with simple hyperplasia without atypia; while 7.1 percent of the cases showed atypia. The associated risk factor was obesity in 46.1 percent of cases. Ultrasound had positivity in patients with atypical endometrial 90.9 percent and 100 percent hysteroscopy. Hormone therapy was used in 67.5 percent of patients and surgical treatment was used in all patients with cellular atypia. Conclusions: there was a predominance of endometrial hyperplasia without atypia in women aged between 41 and 60 and with low parity and a low occurrence of atypical hyperplasia(AU)
Asunto(s)
Humanos , Femenino , Hiperplasia Endometrial/epidemiología , Hiperplasia Endometrial/cirugía , Hiperplasia Endometrial/patología , Epidemiología Descriptiva , Estudios Observacionales como AsuntoRESUMEN
Se realizó una investigación retrospectiva y analítica, con el objetivo de identificar los factores de riesgo asociados a las lesiones endometriales en las mujeres obesas mayores de 50 años en el municipio Pinar del Río. El universo de estudio estuvo constituido por la totalidad de las mujeres residentes en el área de salud Hermanos Cruz. Se seleccionó un grupo de estudio conformado por las mujeres obesas mayores de 50 años y un grupo de control conformado por las mujeres mayores de 50 años no obesas. Para obtener los datos, se utilizó una encuesta-formulario, donde se incluyeron variables generales de la mujer, antecedentes personales y familiares e historia ginecobstétrica, la cual fue aplicada a ambos grupos, con previo consentimiento. Se realizó un estudio ultrasonográfico a las mujeres incluidas en la investigación y uno histológico del endometrio cuando el examen ultrasonográfico resultó anormal (mayor de 4 mm en posmenopáusicas y de 14 mm en premenopáusicas.). Se confeccionó una base de datos con las variables estudiadas. Los resultados obtenidos se agruparon en cuadros (simples y de contingencia). Para su procesamiento estadístico se utilizaron la frecuencia absoluta y porcentual, el estadígrafo Ji cuadrado, pruebas de probabilidad de Fisher, los odds ratio (crudo y ponderado) y Z. La obesidad estuvo asociada con mayor probabilidad de tener un resultado ultrasonográfico anormal de la medida del grosor endometrial y de lesiones premalignas y cáncer endometrial, principalmente cuando existieron antecedentes familiares de cáncer de mama o colon y antecedentes personales de menarquía precoz, paridad y sangrado uterino anormal...(AU)
A retrospective and analytic research was carried out with the purpose of identifying risk factors associated with endometrial lesions in obese women older than 50 years old in Pinar del Rio municipality. The universe was comprised of the total of women living at Hermanos Cruz health sector. A group of obese women older than 50 years old and a control group of non-obese women older than 50 years old were chosen. To collect data, a survey-form was used; including general variables of women, personal, familial, gynecological and obstetric records. The survey was applied for both groups having a previous consent. A sonographic study was conducted to women participating in the research and performing an endometrial-histological examination when the Sonography showed abnormalities (greater 4mm in postmenopausal and 14mm in premenopausal women). A database using the variables studied was created; and the results were grouped in charts (simple and of contingency). In the statistical process absolute frequency and percentage, chi square, Fishers probability test, odds ratio (raw and adjusted), and Z test were used. Obesity was associated with a major probability of having an abnormal sonographic result of the endometrial thickness, premalignant lesions and endometrial cancer; mainly when familial history of breast or colon cancers existed as well as personal records of early menarche, parity and abnormal uterine bleeding...(AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Hiperplasia Endometrial/epidemiología , Biopsia , Adenocarcinoma/epidemiología , Neoplasias Endometriales/epidemiologíaRESUMEN
Antecedentes: La hiperplasia endometrial es una entidad en la que existe una proliferación de glándulas endometriales de tamaño y forma irregular, con mayor proporción de glándulas sobre el estroma, a consecuencia de una excesiva exposición a los estrógenos. Aproximadamente, en el 15 por ciento de legrados/biopsias endometriales de mujeres postmenopausicas con cuadro clínico de hemorragia uterina anormal, se diagnostica esta entidad. Objetivo: Describir la incidencia y hallazgos histopatológicos en legrado/biopsia endometrial en pacientes de un hospital público de tercer nivel. Métodos: Se revisaron 22.048 procedimientos realizados en el Hospital Universitario de Santander, procesados en el Departamento de Patología de la Universidad Industrial de Santander, en el periodo comprendido entre 1 de enero de 2005 y 31 de diciembre 2008, de los cuales 1.750 correspondieron a legrados/biopsias de endometrio y en 168 de estos se realizó el diagnóstico histopatológico de hiperplasia endometrial. Resultados: Se encontró que el promedio de edad de presentación de está entidad fue de 44,8 años y que el mayor porcentaje de pacientes (68,5 por ciento) estuvieron en el grupo de la hiperplasia simple sin atipia. En el 19,7 por ciento de los casos hubo evidencia de atipia. Conclusiones: El promedio de edad encontrado y los porcentajes por subgrupos de hiperplasia estuvieron en relación a otros estudios. Se destaca una menor proporción de casos con atipia.
Background: Endometrial hyperplasia is an entity in which there is a proliferation of endometrial glands of irregular size and shape, with the highest proportion of glands on the stroma, resulting from excessive exposure to estrogen. Approximately 15 percent of curettages/endometrial biopsies of postmenopausal women with clinical symptoms of abnormal uterine bleeding is diagnosed this entity. Objective: To describe the incidence and pathological findings in curettage/endometrial biopsy in patients of a tertiary public hospital. Methods: A retrospective review of 22,048 surgical procedures performed in the University Hospital of Santander, processed in the Pathology Department of Industrial University of Santander in the period from 1 January 2005 and 31 December 2008, of which 1,750 corresponded to curettage/biopsy of the endometrium and in 168 of these histopathological diagnosis was made of endometrial hyperplasia. Results: We found that the average age of presentation in this institution was 44.8 years and that the greater percentage of patients (68.5 percent) were in the group of simple hyperplasia without atypia. In 19.7 percent of the cases had evidence of atypia. Conclusions: The mean age and percentages found by hyperplasia subgroups were relatively within limits with regard to other studies, although broadly outlined in a lower proportion of cases with atypia.
Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Hiperplasia Endometrial/epidemiología , Hiperplasia Endometrial/patología , Factores de Edad , Biopsia , Hemorragia Uterina/etiología , Hiperplasia Endometrial/clasificación , Incidencia , Estudios Retrospectivos , Factores de RiesgoRESUMEN
BACKGROUND: Obesity is a public health problem and it is necessary to identify if non-symptomatic obese women must be submitted to endometrial evaluation. AIMS: To determine the prevalence of endometrial hyperplasia and cancer in non-symptomatic overweight or obese women. METHODS: A cross-sectional study was carried out in 193 women submitted to an endometrial biopsy using a Pipelle de Cornier. The findings were classified as normal, hyperplasia or cancer, and the results were compared to body mass index (BMI; kg/m(2)). For the purpose of statistical analysis, women were divided into two groups: women of reproductive age and postmenopausal women, and according to BMI as overweight or obese. RESULTS: The prevalence of endometrial cancer and hyperplasia was 1.0% and 5.8% in women of reproductive age and 3.0% and 12.1% in postmenopausal women, respectively. According to logistic regression, being in the postmenopause increased the risk of endometrial hyperplasia and cancer to 1.19 (95% confidence interval (CI): 0.36-3.90), while being postmenopausal and severely obese increased the odds ratio (OR) to 1.58 (95%CI: 0.30-8.23) and being postmenopausal and morbidly obese increased the OR to 2.72 (95%CI: 0.65-11.5). No increase in risk was found in women of reproductive age who were either overweight or obese. DISCUSSION: Our results show that non-symptomatic, severe or morbidly obese postmenopausal women have a high risk of developing endometrial hyperplasia or cancer; however, no such risk was found for women of reproductive age.
Asunto(s)
Hiperplasia Endometrial/epidemiología , Neoplasias Endometriales/epidemiología , Obesidad/complicaciones , Adulto , Factores de Edad , Anciano , Índice de Masa Corporal , Estudios de Cohortes , Estudios Transversales , Hiperplasia Endometrial/patología , Neoplasias Endometriales/patología , Femenino , Humanos , Persona de Mediana Edad , Obesidad/patología , Posmenopausia , Premenopausia , Prevalencia , Factores de RiesgoRESUMEN
OBJECTIVE: Obesity represents the most important risk factor for endometrial pathology. This study aimed to evaluate the prevalence of endometrial injuries, such as polyps, hyperplasia and endometrial cancer in asymptomatic obese women, as well as to recognize the associated risk factors . METHODS: A cross-sectional study was conducted between December 2004 and February 2006. Ninety-four obese (body mass index > or = 30 kg/m2) women were evaluated, divided in two groups of 47 participants each: pre-menopausal and postmenopausal women. Clinical characteristics, physical exams (anthropometric and gynecological), blood count and endometrial assessment by vaginal ultrasonography, biopsy, and hysteroscopy (only for confirmed endometrial pathology), were the variables appraised. RESULTS: In pre-menopausal women, 12.8% of cases had endometrial pathology statistically associated to age, hypertension, hypercholesterolemia and LDL-c increase. In the post-menopausal women, 40.4% of cases had a pathology identified as statistically associated with hypertension, LDL-c and estrone increase. Two cases of endometrial cancer were identified, one in each group. CONCLUSIONS: The increased incidence of obesity over recent years has increased risk factors of endometrial cancer. In pre-menopausal women only a small number of cases with endometrial alterations was observed. Therefore, it is suggested that greater attention be given to those over 40 years of age, associated with hypertension and/or higher LDL-c . The menopausal status increases risk of endometrial injury, and when associated with hypertension, LDL-c and/or estrone increase, women become candidates to biopsy aiming for an early diagnosis of cancer, a decisive factor for a favorable prognosis.
Asunto(s)
Hiperplasia Endometrial/epidemiología , Neoplasias Endometriales/epidemiología , Endometrio/patología , Obesidad/complicaciones , Pólipos/epidemiología , Adulto , Factores de Edad , Biopsia , Índice de Masa Corporal , Brasil/epidemiología , LDL-Colesterol/efectos adversos , LDL-Colesterol/sangre , Hiperplasia Endometrial/etiología , Hiperplasia Endometrial/patología , Neoplasias Endometriales/etiología , Neoplasias Endometriales/patología , Endometrio/diagnóstico por imagen , Métodos Epidemiológicos , Femenino , Humanos , Hipertensión/complicaciones , Histeroscopía , Persona de Mediana Edad , Obesidad/sangre , Obesidad/diagnóstico , Pólipos/etiología , Pólipos/patología , Posmenopausia , Premenopausia , Valores de Referencia , UltrasonografíaRESUMEN
OBJETIVOS: A obesidade representa importante fator de risco para alterações endometriais. O presente estudo teve por objetivo avaliar a prevalência de lesões endometriais, como pólipos, hiperplasia e câncer de endométrio em mulheres obesas assintomáticas, assim como reconhecer os fatores de risco associados. MÉTODOS: Entre dezembro de 2004 e fevereiro de 2006, em estudo transversal foram avaliadas 94 mulheres obesas (índice de massa corpóreo >30Kg/m²), divididas em dois grupos com 47 participantes cada: em idade reprodutiva e após a menopausa. Foram analisados: história clínica, exame físico (antropométrico/ginecológico), determinações bioquímicas e avaliação do endométrio por ultra-sonografia endovaginal, biópsia e histeroscopia (para confirmar patologia endometrial). RESULTADOS: Nas mulheres em idade reprodutiva foram encontrados 12,8 por cento de casos de patologia endometrial, que se associaram significativamente com as elevações da idade, hipertensão arterial (HAS), colesterol e LDL-c. Após a menopausa, foram identificadas 40,4 por cento de lesões endometriais que se associaram significativamente com pressão arterial sistólica (PAS) > 140mmHg, elevação do LDL-c e da estrona. Dois casos de câncer de endométrio foram constatados, sendo um em cada grupo. CONCLUSÃO: O aumento de incidência da obesidade nos últimos anos tem elevado os fatores de risco para o câncer de endométrio. Na idade reprodutiva tivemos um pequeno tamanho amostral de alterações endometriais; com isso, poderíamos apenas sugerir, uma maior atenção àquelas com idade superior a 40 anos, que apresentem HAS e/ou elevação do LDL-c. O status menopausal eleva o risco de lesão endometrial; associado com elevações da PAS, LDL-c e/ou estrona, elas se tornarão candidatas à biópsia de endométrio, visando o diagnóstico precoce do câncer, decisivo para o prognóstico favorável da mulher.
OBJECTIVE: Obesity represents the most important risk factor for endometrial pathology. This study aimed to evaluate the prevalence of endometrial injuries, such as polyps, hyperplasia and endometrial cancer in asymptomatic obese women, as well as to recognize the associated risk factors . METHODS: A cross-sectional study was conducted between December 2004 and February 2006. Ninety-four obese (body mass index > 30 kg/m²) women were evaluated, divided in two groups of 47 participants each: pre-menopausal and postmenopausal women. Clinical characteristics, physical exams (anthropometric and gynecological), blood count and endometrial assessment by vaginal ultrasonography, biopsy, and hysteroscopy (only for confirmed endometrial pathology), were the variables appraised. RESULTS: In pre-menopausal women, 12.8 percent of cases had endometrial pathology statistically associated to age, hypertension, hypercholesterolemia and LDL-c increase. In the post-menopausal women, 40.4 percent of cases had a pathology identified as statistically associated with hypertension, LDL-c and estrone increase. Two cases of endometrial cancer were identified, one in each group. CONCLUSIONS: The increased incidence of obesity over recent years has increased risk factors of endometrial cancer. In pre-menopausal women only a small number of cases with endometrial alterations was observed. Therefore, it is suggested that greater attention be given to those over 40 years of age, associated with hypertension and/or higher LDL-c . The menopausal status increases risk of endometrial injury, and when associated with hypertension, LDL-c and/or estrone increase, women become candidates to biopsy aiming for an early diagnosis of cancer, a decisive factor for a favorable prognosis.
Asunto(s)
Adulto , Femenino , Humanos , Persona de Mediana Edad , Hiperplasia Endometrial/epidemiología , Neoplasias Endometriales/epidemiología , Endometrio/patología , Obesidad/complicaciones , Pólipos/epidemiología , Factores de Edad , Biopsia , Índice de Masa Corporal , Brasil/epidemiología , LDL-Colesterol/efectos adversos , LDL-Colesterol/sangre , Hiperplasia Endometrial/etiología , Hiperplasia Endometrial/patología , Neoplasias Endometriales/etiología , Neoplasias Endometriales/patología , Endometrio , Métodos Epidemiológicos , Hipertensión/complicaciones , Histeroscopía , Obesidad/sangre , Obesidad/diagnóstico , Pólipos/etiología , Pólipos/patología , Posmenopausia , Premenopausia , Valores de ReferenciaRESUMEN
OBJETIVOS:Testar a correlaçäo entre variáveis clínico-epidemiológicas com o achado de atipia em pacientes com hiperplasia endometrial. CASUISTICA E METODOLOGIA: Estudo retrospectivo tipo caso-controle, no qual foram analisadas 120 pacientes com hiperplasia endometriais, divididas em típicas e atípicas. Pesquisou-se a idade; antecedentes obstétricos; estado da funçäo reprodutora; padräo menstrual; hipertensäo, diabete e obesidade; diagnóstico concomitante de mioma e pólipo endometrial. RESULTADOS: As pacientes com atipia endometrial tinham em média 5 anos a mais que aquelas sem atipia (51,2 x 45,9). Cerca de 48 por cento delas encontravam-se na pós-menopausa, o que verificou-se em apenas 20 por cento das formas típicas. A paridade média foi de 4,5, näo havendo diferenças entre os grupos. Em 80 por cento dos casos havia sangramento uterino anormal, independente da presença de atipia. Näo foram encontradas diferenças significativas na freqüência de hipertensäo, obesidade e diabete bem como na concomitância de pólipos e miomas entre os grupos estudados. CONCLUSOES: As pacientes com hiperplasia endometrial atípica diferiram daquelas sem atipia apenas pela idade mais avançada (5 anos em média) e pelo estado menopausal. Por apresentarem o mesmo perfil clínico epidemiológico supöe-se que ambas sejam estágios progressivos da história natural do câncer de endométrio
Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Hiperplasia Endometrial/epidemiología , Menopausia , PosmenopausiaRESUMEN
Verifica a incidência das hiperplasias e câncer do endométrio na cidade de Caxias do Sul e caracteriza o perfil das mulheres portadoras destas neoplasias. Estuda 103 pacientes que tiveram diagnóstico de hiperplasia simples com atipia, hiperplasia complexa com e sem atipia e câncer endometrial. Foram realizados testes näo paramétricos para as variáveis como idade, estado marital, cor, profissäo, peso, altura, obesidade, índice de massa corpórea (IMC), hipertensäo, diabetes, fumo, paridade, idade da menarca e menopausa, anticoncepçäo hormonal oral (ACO) e terapia de reposiçäo hormonal (TRH). Para análise de tendência linear do risco oncológico, utiliza o teste do Qui-quadrado. Verifica que 78 por cento das pacientes tinham mais de 50 anos; 97,1 por cento eram brancas; 75,7 por cento eram casadas; 77,6 por cento eram donas de casa; 77,7 eram näo-fumantes. A idade da menarca foi de 12,5 anos e da menopausa 51,3 anos em média. Observa que 7,8 por cento eram nulíparas e 49,5 por cento tiveram entre 3 e 5 gestaçöes. Encontraram-se 52,4 por cento que usavam ACO e 44,7 por cento TRH. Cerca de 41,7 por cento eram hipertensas; 16,5 por cento diabéticas; 48,5 por cento obesas; 73,8 por cento tinham IMC acima de 25. Verifica uma incidência de 13,3/100.000 mulheres em 1995 e 11,7/100.000 em 1996 para o câncer endometrial. A incidência em Caxias do Sul de câncer endometrial foi elevada quando comparada com as demais regiöes do país. Observa também uma tendência linear positiva e significativa entre obesidade e risco oncológico
Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Hiperplasia Endometrial/epidemiología , Neoplasias Endometriales/epidemiología , Brasil , Incidencia , Factores de RiesgoRESUMEN
OBJECTIVES: To evaluate the morphologic hysteroscopic criteria leading to a diagnosis of endometrial hyperplasia and compare their accuracy with that of histology. METHODS: A total of 95 hysteroscopic examinations were evaluated. Of these, 37 had a histologic diagnosis of normal endometrium and the remaining 58 of simple or complex endometrial hyperplasia. We compared the morphologic hysteroscopic criteria for the two groups using Pearson's chi-squared and Fisher's exact test. RESULTS: Only the presence of endometrial glands presenting a cystic pattern at hysteroscopy gave statistically significant results (P < 0.05), with low sensitivity (15.79%), high specificity (97.29%) and a relative risk of 6.75. With a prevalence of endometrial hyperplasia of 22.97% in a population of women with metrorrhagia, the positive predictive value was 63.53% and the negative predictive value was 79.40%. CONCLUSION: Additional, prospective studies are needed to determine the real value of the diagnostic morphologic parameters under consideration.
Asunto(s)
Hiperplasia Endometrial/patología , Histeroscopía/métodos , Adulto , Biopsia con Aguja , Diagnóstico Diferencial , Hiperplasia Endometrial/diagnóstico , Hiperplasia Endometrial/epidemiología , Femenino , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Prevalencia , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
Foi procedido um levantamento das pacientes atendidas no período de janeiro de 1984 a janeiro de 1986, selecionando-se os casos de endometriose e adenomiose comprovados por exame anatomopatológico, de um total de 551 laparotomias. Foram analisadas 99 pacientes quanto às alteraçöes histopatológicas associadas, grau de paridade, idade e cor, separadas em três grupos: as que apresentavam adenomiose (90), as que tinham adenomiose associada a endometriose e as que eram portadoras apenas de endometriose. Verificou que a alteraçäo histopatológica mais freqüentemente associada à adenomiose foi a hiperplasia de endométrio em 55 casos (39,3%), sendo ela também mais freqüente com o grupo de adenomiose mais endometriose em 5 casos (33,5%). As endometrioses tubária e ovariana associaram-se ao mioma, em quatro casos (40%). A maior incidência concentrou-se no grupo de mulheres de 1 a 3 filhos em 41 casos (45,5%), na 5a. década de vida em 60 casos (60,6%), sendo brancas em 61 casos (61,6%)