Abstract
Aim. Atypical endometrial hyperplasia (AEH) is a strong predictor of endometrial cancer, which is responsible for 80% of endometrial malignancies; out of all patients AEH, 10-50% are further diagnosed with endometrial cancer. Here we developed an algorithm for calculating the risk of AEH ma-lignisation in women of reproductive age. Materials and Methods . Our study included 143 women of reproductive age with a histologically confirmed endometrial hyperplasia. Patients were further divided into those having AEH and non-atypical endometrial hyperplasia. Control group included 56 women with abnormal uterine bleeding without endometrial hyperplasia, adeno-myosis, uterine fibroids, and cancer. We then performed binary logistic regression model for the identification of significant risk factors of AEH malignisation. Results. Among the significant risk factors were miRNA levels (miR-210, miR-18a, miR-221, miR-222), pyruvate kinase M2, pelvic inflammatory disease (OR = 7.73), adenomyosis (OR = 3.34), benign mammary dysplasia (OR = 3.21), and uterine fibroids in conjunction with adenomyosis (OR = 8.34). Conclusion. Our results show that every third patient with AEH has a risk of its malignisation to endometrial cancer. We also developed an algorithm for calculating the individual risk of such event.
Highlights
Our results show that every third patient with Atypical endometrial hyperplasia (AEH) has a risk of its malignisation to endometrial cancer
Our results show that every third patient with AEH has a risk of its malignisation to endometrial cancer
We developed an algorithm for calculating the individual risk of such event
Summary
ПРОГНОЗИРОВАНИЕ РИСКА ОЗЛОКАЧЕСТВЛЕНИЯ ГИПЕРПЛАЗИИ ЭНДОМЕТРИЯ В РЕПРОДУКТИВНОМ ВОЗРАСТЕ. Разработать алгоритм расчета риска озлокачествления гиперплазии эндометрия для женщин в репродуктивном возрасте. В исследование включены 143 женщины репродуктивного возраста с ГЭ, подтвержденной гистологически. В математическую модель прогнозирования риска малигнизации ГЭ включены генетические (miR-210, miR-18a, miR-221, miR-222), метаболические (пируваткиназа М2) маркеры и клинико-анамнестические факторы (выявлены высокие шансы злокачественной трансформации при наличии воспалительных заболеваний органов малого таза (ОШ=7,73), аденомиоза (ОШ=3,34), доброкачественной дисплазии молочных желез (ОШ=3,21), миомы матки в сочетании с аденомиозом (ОШ=8,34). На основе модели бинарной логистической регрессии разработан алгоритм расчета индивидуального риска малигнизации ГЭ. Разработанный алгоритм позволяет ранжировать пациенток с гиперплазией эндометрия по риску озлокачествления, учитывая анамнестические данные, эпигенетические (miR-210, miR-18а, miR221, miR222), метаболические (пируваткиназа М2) маркеры и может быть использован для обоснования тактики ведения пациенток репродуктивного возраста. Прогнозирование риска озлокачествления гиперплазии эндометрия в репродуктивном возрасте.
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