Abstract
Recent scientific studies show that fat tissue is not a passive metabolism depot, as previously thought, but manifests itself as an active endocrine organ. Pathological processes occurring in adipose tissue with its hypertrophy during weight gain are considered links in carcinogenesis in more than 20% of malignant tumors, including endometrial and breast cancer.The aim of the research was to study the effect of excess weight (BMI >30) on the development of endometrial hyperplasia in women of reproductive age and in menopause.The medical histories of 62 patients from 2016 to 2018 with diagnoses of endometrial hyperplasia without atypia and endometrial hyperplasia with atypia were reviewed in a retrospective study according to pathological histology after hysteroscopy. Depending on the reproductive status and body mass index, four groups of patients were formed.Obtained data showed that in women with obesity, the percentage of atypical hyperplasia (65.9%) was significantly higher than in women with normal body weight (28.6%). In young women with overweight, the percentage of atypical hyperplasia was 57.9%, while for BMI <30 – 16.7%. In women of menopausal age with a BMI >30 percent of atypical hyperplasia, 68.2%, while with a BMI <30 – 33.3%. In women of menopausal age with a BMI >30 percent of atypical hyperplasia is 64.9%, while in young women with a BMI >30 – 48%.The results of the study show that atypical hyperplasia of the endometrium is more often detected in the presence of excessive body weight, and the risk of its development among obese women of menopausal age is comparatively higher than in obese young women. Since the probability of progression of endometrial cancer is increased 45 times within 1 year if the diagnosis of endometrial hyperplasia is confirmed histologically, weight correction is a method of preventing the development of atypical changes in the endometrium at any age.
Highlights
AND ANALYSIS OF THE LITERATURE DATA According to the National Cancer Registry of Ukraine, the proportion of malignant neoplasms of the uterus body in the structure of the incidence of the female population ranked second (10.4%) in 2016 after breast cancer (23.2%), with the exception of non-melanoma skin diseases [1]
Progression of simple endometrial hyperplasia in a highly differentiated endometrial carcinoma occurs in 1–3% of women
From 1/4 to 1/3 of women with atypical hyperplasia detected by biopsy results, endometrial cancer will be diagnosed after an immediate hysterectomy or during the first year of conservative management
Summary
AND ANALYSIS OF THE LITERATURE DATA According to the National Cancer Registry of Ukraine, the proportion of malignant neoplasms of the uterus body in the structure of the incidence of the female population ranked second (10.4%) in 2016 after breast cancer (23.2%), with the exception of non-melanoma skin diseases [1]. Late detection and imperfect prediction of the endometrial adenocarcinoma development factors lead annually to a huge number of hysterectomies depriving woman of the opportunity to realize her reproductive potential. According to the 2014 edition Classification of Tumors of the Reproductive Bodies of the WHO, the risk of developing endometrial carcinoma increases by 3–4 times in women who are exposed to “undisguised” estrogens (for various reasons), and at a persistence of this condition 10 times over 10 years [4]. Progression of simple endometrial hyperplasia in a highly differentiated endometrial carcinoma occurs in 1–3% of women. From 1/4 to 1/3 of women with atypical hyperplasia detected by biopsy results, endometrial cancer will be diagnosed after an immediate hysterectomy or during the first year of conservative management
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