J Gynecol Oncol.  2013 Jan;24(1):14-20. 10.3802/jgo.2013.24.1.14.

Risk factor analysis of coexisting endometrial carcinoma in patients with endometrial hyperplasia: a retrospective observational study of Taiwanese Gynecologic Oncology Group

• Chen YL
• Wang KL
• Chen MY
• Yu MH
• Wu CH
• Ke YM
• Chen YJ
• Chang YY
• Hsu KF
• Yen MS

• KMID: 2288556
• DOI: http://doi.org/10.3802/jgo.2013.24.1.14

Abstract

OBJECTIVE
To evaluate the clinical outcome and parameters related to coexisting endometrial carcinoma in women with tissue-diagnosed endometrial hyperplasia.
METHODS
Between January 1991 and December 2009, three hundred and eighty-six patients with the presumptive diagnosis of endometrial hyperplasia were retrieved. Among these, one hundred and twenty-five patients were identified as having coexisting endometrial carcinoma in hysterectomy specimens. The three hundred and eighty-six patients were divided into two groups: the hyperplasia-benign group (261 cases) and the hyperplasia-malignant group (125 cases). Several clinical parameters including age, menopausal status, history of abnormal uterine bleeding, obstetrical history, medical history of diabetes and hypertension, BMI, and preoperative pathologic results were investigated.
RESULTS
Age > or =53 (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.26 to 4.57), menopausal status (OR, 2.07; 95% CI, 1.14 to 3.76), diabetes history (OR, 7.33; 95% CI, 2.79 to 19.26), abnormal uterine bleeding (OR, 3.99; 95% CI, 1.22 to 13.02), atypical endometrial hyperplasia (OR, 7.38; 95% CI, 4.03 to 13.49), and body mass index > or =27 (OR, 3.24; 95% CI, 1.76 to 5.97) were independent risk factors for prediction of endometrial hyperplasia coexisting with endometrial carcinoma. The diagnostic efficacy of atypical endometrial hyperplasia to predict the endometrial hyperplasia coexisting with endometrial carcinoma was better than or similar to those of other independent factors and combinations of these factors.
CONCLUSION
Coexisting malignancy should be considered when examining endometrial hyperplasia patients with the related risk factors, especially atypical endometrial hyperplasia.

Keyword

Coexisting endometrial carcinoma; Endometrial hyperplasia; Hysterectomy; Risk factors

MeSH Terms

Body Mass Index
Endometrial Hyperplasia
Endometrial Neoplasms
Female
Humans
Hypertension
Hysterectomy
Retrospective Studies
Risk Factors
Uterine Hemorrhage

Figure

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  Fig. 1 The area under curve (AUC) of receiver operating characteristic (ROC) curve of atypical endometrial hyperplasia (AEH) was 71.8%. The AUC of ROC curve of AEH and history of abnormal uterine bleeding was 72.0%.

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