A modern view on the study of risk factors leading to endometrial hyperplasia malignization: A literature review

Authors

  • B.I. Imasheva KSPH Health Care
  • M.A. Kamaliev
  • V.N. Lokshin
  • M.A. Baimuratova
  • A.D. Turekhanova

DOI:

https://doi.org/10.37800/RM.3.2022.22-31

Keywords:

endometrial hyperplasia, endometrial cancer, risk factors, predictors, recurrence of endometrial hyperplasia, atypical endometrial hyperplasia, morbidity

Abstract

Relevance: Endometrial hyperplasia is the most urgent problem in the structure of gynecological diseases due to the high possibility of recurrence, difficulties in differential diagnosis, and the risk of malignancy in the absence of patient control
and management. In this connection, the improvement of diagnostics and the study of additional risk factors and predictors of endometrial hyperplasia, as well as methods of preventing this disease, should be considered important aspects of cancer prevention.
The study aimed to generalize and determine the significance of major risk factors for endometrial cancer in patients with endometrial hyperplasia.
Methods: The conducted analytical review included open-access sources from scientific databases and specialized search engines PubMed, Mendeley, Scopus, Web of Science, and Google Scholar over the past decade (2012-2022).
Results: This article describes in detail the risk factors leading to the transformation of endometrial hyperplasia into endometrial cancer. It was noted that endometrial pathologies, especially malignant processes, become more frequent with age, especially after 60 years. The leading anamnestic risk factors for endometrial cancer in women with endometrial hyperplasia
have been identified. The role of genetic factors in endometrial hyperplasia malignization was revealed. The authors reviewed the data of patients at risk for endometrial hyperplasia malignization, in whom endometrial hyperplasia was detected only by ultrasound or histological examination.
Conclusion: The literature review showed that expanding knowledge about the risk factors for hyperplasia degeneration into endometrial cancer is of practical importance for primary health care to improve indicators for early detection and timely treatment of background gynecological diseases.

References

Prip C.M., Stentebjerg M., Bennetsen M.H., Petersen L.K., Bor P. Risk of atypical hyperplasia and endometrial carcinoma after initial diagnosis of non-atypical endometrial hyperplasia: A long-term follow-up study // PLoS ONE. – 2022. – Vol. 17 (4). – Art. ID: e0266339. https://doi.org/10.1371/journal.pone.0266339

Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries // CA Cancer J Clin. – 2021. – Vol. 71(3). – P. 209-249. https://doi.org/10.3322/caac.21660

Natarajan P., Vinturache A., Hutson R., Nugent D., Broadhead T. The value of MRI in management of endometrial hyperplasia with atypia // World J. Surg. Oncol. – 2020. – Vol. 18. – Art. ID: 34 (2020). https://doi.org/10.1186/s12957-020-1811-5

Siegel R.L., Miller K.D., Fuchs H.E., Jemal A. Cancer statistics, 2022 // CA Cancer J Clin. – 2022. – Vol. 72 (1). – P. 7-33. https://doi.org/10.3322/caac.21708

Гусейнова Р. Г., Ордиянц И.М., Ямурзина А.А., Саргсян Н.Л., Исмаилзаде С.Я. Злокачественная трансформация гиперплазированного эндометрия: эпидемиология и прогнозирование // Акушерство и Гинекология. – 2020. – Т. 8(29). – С. 100-105 [Gusejnova R. G., Ordiyanc I.M., Yamurzina A.A., Sargsyan N.L., Ismailzade S.Ya. Zlokachestvennaya transformaciya giperplazirovannogo e’ndometriya: e’pidemiologiya i prognozirovanie // Akusherstvo i Ginekologiya. – 2020. – T. 8(29). – S. 100-105 (in Russ.)]. https://elibrary.ru/item.asp?id=44881494

Кайдарова Д.Р., Балтабеков Н.Т. Показатели онкологической службы Республики Казахстан за 2019 г_09.02.2021 [Kajdarova D.R., Baltabekov N.T. Pokazateli onkologicheskoj sluzhby Respubliki Kazaxstan za 2019 g._09.02.2021 (in Russ.)]. https://onco.kz/o-rake/ponimanie-raka/statistika-raka/. 07.11.2022

Clarke M.A., Long B.J., Del Mar Morillo A., Arbyn M., Bakkum-Gamez J.N., Wentzensen N. Association of Endometrial Cancer Risk With Postmenopausal Bяleeding in Women // JAMA Intern. Med. – 2018. – Vol. 178(9). – P. 1210-1222. https://doi.org/10.1001/jamainternmed.2018.2820

Gokula Priya M., Bargavi E., Julega K. S. An overview of endometrial hyperplasia // JMPAS. – 2021. – Vol. 4. – P. 16-21. https://jmpas.com/doi.org/1621105560

Ørbo A., Arnes M., Vereide A., Straume B. Relapse risk of endometrial hyperplasia after treatment with the levonor0gestrel-impregnated int(1rauterine system or oral progestogens // Bjog. – 2016. – Vol. 123(9). – P. 1512-1519. https://doi.org/10.1111/1471-0528.13763

Sobczuk K., Sobczuk A. New classification system of endometrial hyperplasia WHO 2014 and its clinical implications // Przeglad Menopauzalny. – 2017. – Vol.16(3). – P. 107-111. https://doi.org/10.5114/pm.2017.70589

Gallos I.D., Krishan P., Shehmar M., Ganesan R., Gupta J.K. Relapse of endometrial hyperplasia after conservative treatment: a cohort study with long-term follow-up // Hum. Reprod. – 2013. – Vol. 28(5). – P. 1231-1236. https://doi.org/10.1093/humrep/det049

Zhao J., Hu Y., Zhao Y., Chen D., Fang T., Ding M. Risk factors of endometrial cancer in patients with endometrial hyperplasia: implication for clinical treatments // BMC Womens Health. – 2021. – Vol. 21. –Art. ID: 312 (2021). https://doi.org/10.1186/s12905-021-01452-9

Rodriguez A.M., Polychronopoulou E., Hsu E., Shah R., Lamiman K., Kuo Y.F. Factors Associated with Endometrial Cancer and Hyperplasia among Middle-Aged and Older Hispanics // Gynecol Oncol. – 2021. – Vol. 160(1). – P. 16-23. https://doi.org/10.1016/j.ygyno.2020.10.033

Emons G., Beckmann M.W., Schmidt D., Mallmann P. New WHO Classification of Endometrial Hyperplasias // Geburtshilfe Frauenheilkd. – 2015. – Vol. 75(2). – P. 135-136. https://doi.org/10.1055/s-0034-1396256

Doherty M.T., Sanni O.B., Coleman H.G., Cardwell C.R., McCluggage W.G., Quinn D. Concurrent and future risk of endometrial cancer in women with endometrial hyperplasia: A systematic review and metaanalysis // PLOS ONE. – 2020. – Vol. 15(4). – P. 231-232. https://doi.org/10.1371/journal.pone.0232231

Cong Q., Luo L., Fu Z., Lu J., Jiang W., Sui L. Histopathology of women with non-uniform endometrial echogenicity and risk factors for atypical endometrial hyperplasia and carcinoma // Am. .J Transl. Res. – 2021. – Vol. 13(5). – P. 4500-4509. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205758/

Staples J.N., Rauh L., Peach M.S., Baker W.D., Modesitt S.C. Endometrial cancer in an increasingly obese population: Exploring alternative options when surgery may not cut it // Gynecol. Oncol. Rep. – 2018. – Vol. 25. – P. 30-34. https://doi.org/10.1016/j.gore.2018.04.009

Walsh D.M., Hokenstad A.N., Chen J., Sung J., Jenkins G.D., Chia N. Postmenopause as a key factor in the composition of the Endometrial Cancer Microbiome // Sci. Rep. – 2019. – Vol. 9(1). – P. 192-213. https://doi.org/10.1038/s41598-019-55720-8

Heller D.S., Mosquera C., Goldsmith L.T., Cracchiolo B. Body mass index of patients with endometrial hyperplasia: comparison to patients with proliferative endometrium and abnormal bleeding // J. Reprod. Med. – 2011. – Vol. 56(3-4). – P. 110-122. https://doi.org/10.2154/s25265-012-55670-7

Giannella L., Cerami L.B., Setti T., Bergamini E., Boselli F. Prediction of Endometrial Hyperplasia and Cancer among Premenopausal Women with Abnormal Uterine Bleeding // BioMed Res. Int. – 2019. – Vol. 18. – P. 85-98. https://doi.org/10.3390/diagnostics10070474

Matsuo K., Ramzan A.A., Gualtieri M.R., Mhawech-Fauceglia P., Machida H., Moeini A. Prediction of concurrent endometrial carcinoma in women with endometrial hyperplasia // Gynecol. Oncol. – 2015. – Vol. 39(2). – P. 261-267. https://doi.org/10.1016/j.ygyno.2015.07.108

Onstad M.A., Schmandt R.E., Lu K.H. Addressing the Role of Obesity in Endometrial Cancer Risk, Prevention, and Treatment // J. Clin. Oncol. – 2016. – Vol. 34(35). – P. 4225-4230. https://doi.org/10.1200/JCO.2016.69.4638

Beavis A.L., Cheema S., Holschneider C.H., Duffy E.L., Amneus M.W. Almost half of women with endometrial cancer or hyperplasia do not know that obesity affects their cancer risk // Gynecol. Oncol. Rep. – 2015. – Vol. 13. – P. 71-75. https://doi.org/10.1016/j.gore.2015.07.002

Li X., Fan Y., Wang J., Zhou R., Tian L., Wang Y. Insulin Resistance and Metabolic Syndrome Increase the Risk of Relapse For Fertility Preserving Treatment in Atypical Endometrial Hyperplasia and Early Endometrial Cancer Patients // Front Oncol. – 2021. – Vol. 11. – P. 689-744. https://doi.org/10.3389/fonc.2021.744689

Raffone A., Travaglino A., Saccone G., D’Alessandro P., Arduino B., Mascolo M. Diabetes Mellitus Is Associated with Occult Cancer in Endometrial Hyperplasia // Pathol. Oncol. Res. – 2020. – Vol. 6(3). – P. 1377-1384. https://doi.org/10.1007/s12253-019-00684-3.

Nees L.K., Heublein S., Steinmacher S., Juhasz-Böss I., Brucker S., Tempfer C.B. Endometrial hyperplasia as a risk factor of endometrial cancer // Arch. Gynecol. Obstet. – 2022. – Vol. 306(2). – P. 407-421. https://doi.org/10.1007/s00404-021-06380-5

Furness S., Roberts H., Marjoribanks J., Lethaby A. Hormone therapy in postmenopausal women and risk of endometrial hyperplasia // Cochrane Database Syst. Rev. – 2012. – Vol. 8. – Art. No.: CD000402. https://doi.org/10.1002/14651858.CD000402.pub4

Габидуллина Р.И., Смирнова Г.А., Нухбала Ф.Р., Валеева Е.В., Орлова Ю.И., Шакиров А.А. Гиперпластические процессы эндометрия: современная тактика ведения пациенток // Cons. Medicum. – 2019. – Т. 21(6). – С. 53-58 [Gabidullina R.I., Smirnova G.A., Nuxbala F.R., Valeeva E.V., Orlova Yu.I., Shakirov A.A. Giperplasticheskie processy e’ndometriya: sovremennaya taktika vedeniya pacientok // Cons. Medicum. – 2019. – T. 21(6). – S. 53-58 (in Russ.)]. https://consilium.orscience.ru/2075-1753/article/view/96818

Dominick S., Hickey M., Chin J., Su H.I. Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen // Cochrane Database Syst. Rev. – 2015. – Vol.12. – P. 45-72. https://doi.org/10.1002/14651858.CD007245.pub3

Lee M., Piao J., Jeon M.J. Risk Factors Associated with Endometrial Pathology in Premenopausal Breast Cancer Patients Treated with Tamoxifen // Yonsei Med. J. – 2020. – Vol. 61(4). – P. 317-322. https://doi.org/10.3349/ymj.2020.61.4.317

AlZaabi A., AlAmri H., ALAjmi G., Allawati M., Muhanna F., Alabri R., AlBusaidi F., AlGhafri S., AlMirza A.A., Al Balmani K. Endometrial Surveillance in Tamoxifen and Letrozole Treated Breast Cancer Patients // Cureus. – 2021. – Vol. 13(11). – P. 200-230. https://doi.org/10.7759/cureus.20030

Romero S.A., Young K., Hickey M., Su H.I. Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen // Cochrane Database Syst. Rev. – 2020. – Vol.12. – Art. ID: CD007245. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092675/

Wright J.D., Desai V.B., Chen L., Burke W.M,. Tergas A.I., Hou J.Y. Utilization of Gynecologic Services in Women with Breast Cancer Receiving Hormonal Therapy // Am. J. Obstet. Gynecol. – 2017. – Vol. 217(1). – P. 59-62. https://doi.org/10.1016/j.ajog.2017.03.011

Hu R., Hilakivi-Clarke L., Clarke R. Molecular mechanisms of tamoxifen-associated endometrial cancer (Review) // Oncol. Lett. – 2015. – Vol. 9(4). – P. 495-501. https://doi.org/10.3892/ol.2015.2962

Sanderson P.A., Critchley H., Williams A., Arends M.J., Saunders P. New concepts for an old problem: the diagnosis of endometrial hyperplasia // Hum. Reprod. Update. – 2017. – Vol. 23(2). – P. 232-254. https://doi.org/10.1093/humupd/dmw042

Hui L.S., Chin SHM., Goh C., Hui L.X., Mathur M., Kuei T.L.Y., Xian F.C.H. Non-atypical endometrial hyperplasia: risk factors for occult endometrial atypia and malignancy in patients managed with hysterectomy // Obstet. Gynecol. Sci. – 2021. – Vol. 64(3). – P. 300-308. https://doi.org/10.5468/ogs.20294

Wu Q.J., Li Y.Y., Tu C., Zhu J., Qian K.Q., Feng T.B. Parity and endometrial cancer risk: a meta-analysis of epidemiological studies // Sci. Rep. – 2015. – Vol. 5. – Art. ID: 14243 (2015). https://doi.org/10.1038/srep14243

Aldarazi K., Omran H., Jassim N.M. Endometrial hyperplasia in asymptomatic subfertile population // J. Gynecol. Obstet. Hum. Reprod. – 2022. – Vol. 51(4). – Art. ID: 102337. https://doi.org/10.1016/j.jogoh.2022.102337

Petersdorf K., Groettrup-Wolfers E., Overton P.M., Seitz C., Schulze-Rath R. Endometrial hyperplasia in pre-menopausal women: A systematic review of incidence, prevalence, and risk factors // Eur. J. Obstet. Gynecol. Reprod. Biol. – 2022. – Vol. 1(271). – P. 158-171. https://doi.org/10.1016/j.ejogrb.2022.02.015

Visser N.C.M., Sparidaens E.M., Van Den Brink J.W., Breijer M.C., Boss E.A., Veersema S. Long-term risk of endometrial cancer following postmenopausal bleeding and reassuring endometrial biopsy // Acta Obstet. Gynecol. Scand. – 2016. – Vol. 95(12). – P. 1418-1424. https://doi.org/10.1111/aogs.13022

Ozelci R., Dilbaz B., Akpınar F., Kınay T., Baser E., Aldemir O. The significance of sonographically thickened endometrium in asymptomatic postmenopausal women // Obstet. Gynecol. Sci. – 2019. – Vol. 62(4). – P. 273-279. https://doi.org/10.5468/ogs.2019.62.4.273

Giri S.K., Nayak B.L., Mohapatra J. Thickened Endometrium: When to Intervene? A Clinical Conundrum // J. Obstet. Gynaecol. India. – 2021. – Vol. 71(3). – P. 216-225. https://doi.org/10.1007/s13224-020-01415-4

Li J.X.L., Chan F., Johansson C. Can a higher endometrial thickness threshold exclude endometrial cancer and atypical hyperplasia in asymptomatic postmenopausal women? A systematic review // Aust. NZ J. Obstet. Gynaecol. – 2022. – Vol. 62(2). – P. 190-197. https://doi.org/10.3389/fonc.2021.744689

Карапетян О. В. Межклеточные взаимодействия в развитии воспаления, ассоциированного с гиперплазией эндометрия // Крымский журнал экспериментальной и клинической медицины. – 2020. – Т. 10, №3. – С. 125-125 [Karapetyan O. V. Mezhkletochnye vzaimodejstviya v razvitii vospaleniya, associirovannogo s giperplaziej e’ndometriya // Krymskij zhurnal e’ksperimental’noj i klinicheskoj mediciny. – 2020. – T. 10, №3. – S. 125-125] https://cyberleninka.ru/article/n/mezhkletochnye-vzaimodeystviya-v-razvitii-vospaleniya-assotsiirovannogo-s-giperplaziey-endometriya

Kubyshkin A.V., Aliev L.L., Fomochkina I.I., Kovalenko Ye.P., Litvinova S.V. Endometrial hyperplasia related inflammation: its role in the development and progression of endometrial hyperplasia // Inflamm. Res. – 2016. – Vol. 65(10). – P. 785-794. https://doi.org/10.1007/s00011-016-0960-z

Binmahfouz L.S., Eid B.G., Bagher A.M. Estradiol-Induced Endometrial Hyperplasia in Rats by Modulation of NF-κB and Nrf2/HO-1 Axes // Nutrients. – 2022. – Vol. 14(9). – P. 1891-1899. https://doi.org/10.3390/nu14091891

Ордиянц И.М., Куулар А.А., Ямурзина А.А., Гусейнова Р., Новгинов Д.С. Генетические и эпигенетические механизмы развития гиперплазии эндометрия у женщин репродуктивного возраста // Акушерство и гинекология. – 2020. – Т. 8, № 3 (29). – С. 67-70 [Ordiyanc I.M., Kuular A.A., Yamurzina A.A., Gusejnova R., Novginov D.S. Geneticheskie i e'pigeneticheskie mexanizmy razvitiya giperplazii e'ndometriya u zhenshhin reproduktivnogo vozrasta // Akusherstvo i ginekologiya. – 2020. – T. 8, № 3 (29). – S. 67-70 (in Russ.)]. https://cyberleninka.ru/article/n/geneticheskie-i-epigeneticheskie-mehanizmy-razvitiya-giperplazii-endometriya-u-zhenschin-reproduktivnogo-vozrasta

Lin C.Y., Wu R.C., Yang L.Y. et al.MicroRNAs as Predictors of Future Uterine Malignancy in Endometrial Hyperplasia without Atypia // J. Pers. Med. – 2022. – Vol. 12(2). – P. 311. https://doi.org/10.3390/jpm12020311

Donkers H., Bekkers R., Galaal K. Diagnostic value of microRNA panel in endometrial cancer: A systematic review // Oncotarget. – 2020. – Vol. 11(21). – P. 2010-2023. https://doi.org/10.18632/oncotarget.27601

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Published

2022-12-30

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[1]
Imasheva Б., Kamaliev М., Lokshin В. , Baimuratova М. and Turekhanova А. 2022. A modern view on the study of risk factors leading to endometrial hyperplasia malignization: A literature review . Reproductive Medicine (Central Asia). 4(53) (Dec. 2022), 22–31. DOI:https://doi.org/10.37800/RM.3.2022.22-31.

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No. 4(53) (2022): Reproductive medicine

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