Objective: To determine the prevalence of premalignant and malignant changes in hysteroscopically removed endometrial polyps in reproductive aged women, and to determine clinical, ultrasonographic and hysteroscopic characteristics of such women. Methods: This is a cross-sectional study of patients diagnosed with endometrial polyp, and underwent hysteroscopy from 2015-2019. A review of the medical records (ultrasound results, intraoperative findings and histopathology results) was done. Results: A total of 117 patient records were included in the analysis. The median age of all patients who underwent hysteroscopy was 38 years old (age range: 19-44 years). The prevalence of endometrial hyperplasia or carcinoma in the 18-44 year old age group was 8.5% (n=10/117). Among patients with endometrial hyperplasia or carcinoma, 70% were nulligravid, 40% had anovulation disorder, and 40% had infertility. Most of the patients were overweight or obese (70%). Co-morbidities were present in only 3 cases, and diabetes mellitus (30%) was the predominant illness seen in these patients. Conclusion Our findings showed a higher prevalence (8.5%) of endometrial hyperplasia or carcinoma in endometrial polyps among Filipino reproductive-aged women, compared to reports in published literature. Among the different clinical characteristics, ultrasound and hysteroscopic findings, no particular factor had a significant association with endometrial hyperplasia or malignancy.
Hysteroscopy ; Endometrial Neoplasms ; Endometrial Hyperplasia

A prospective study was performed on 72 endometrial hyperplasia patients who had been treated by progestin from 2000 - 2004. Results: After 3-6 months of the treatment, there were 57 patients recovered completely (79.16%); 10 patients had hysterectomy because of unsuccessful treatment, these patients had uterus polyp, leiomyoma, long bleeding unrespond to treatment; 1 case was defined endometrial cancer afterward. 3 patients had endometrial hyperplasia in endometrial biopsy after 6 months of intensive treatment. Using of progestin in treating endometrial hyperplasia needs an accurate pathological diagnosis of endometrial diseases, the cooperation of doctors and a regular follow- up. Women with endometrial hyperplasia who were treated with progestin had uterus preserved therefore their menstruation became regularly after recovering and; several young women even got pregnant and become a mother.
Endometrial Hyperplasia ; Therapeutics

A study on 216 patients who had endometrial hyperplasia, these patients had been examined and treated from June 1999 to June 2004 at National hospital of Obstetrics and Gynecology. The patients were divided into 2 groups: Group 1 included 108 patients who were given Orgametril 5mgx 2 tablets/day; group 2 included 108 patients who received only consultation and follow up 6 months after being endometrium curetted. Results: After 6 months of treatment with progestin (Orgametril), there were only 3 patients in group 1 had pathological signs of endometrial hyperplasia (2.8%); 94 patients recovered completely (87%). In group 2, there were 74 patients recovered completely (64.8%) and 19 patients had pathological signs of endometrial hyperplasia (17.6%). After being treated, old patients had endometrium changed into menopause stage: atrophy, thinner and stop working, they also did not have menorrhagia anymore.
Menorrhagia ; Endometrial Hyperplasia ; Therapeutics

No abstract available.
Adenocarcinoma* ; Endometrial Hyperplasia* ; Female

Background: Endometrial hyperplasia is a common gynecologic disorder seen in the clinics. Among patients with endometrial hyperplasia, an estimated 5-10% have underlying malignancy hence early diagnosis and management is important. Hysteroscopy, regarded as the gold standard for diagnosing intrauterine abnormalities, enables accurate study of the endometrial surface as well as target eye biopsy during the same procedure. These eye-directed biopsies have a high accuracy in the hands of experienced operators, but accuracy of this technique is dependent on recognition of suspected endometrial pathology.1 Objective: The objective of this study is to ascertain inter-observer agreement in describing hysteroscopic findings among patients with endometrial hyperplasia Methodology: This is a prospective interobserver study of gynecologists from the Department of Obstetrics and Gynecology, St. Luke’s Medical Center. Three invited, consenting gynecologists reviewed 22 hysteroscopy recordings with histologic diagnosis of normal endometrium or endometrial hyperplasia from the files of the section of Minimally Invasive Gynecologic Surgery. Then, evaluation of the hysteroscopy recordings was conducted using an assessment form containing questions about the quality of the recording, characteristics of the endometrium, and their diagnoses. The final outcome of this study is the inter-observer agreement among hysteroscopists in describing hysteroscopic findings of patients with endometrial hyperplasia. Results: There is a wide gap in the interobserver agreement between hysteroscopists in describing hysteroscopic findings of patients with endometrial hyperplasia. However, the interobserver agreement was found to be substantial among participants in identifying the correct diagnosis. Conclusion A clear, systematic and standard way of identifying and describing hysteroscopic findings should be developed and instituted for use among hysteroscopists and hysteroscopy training programs. This will help in precisely identifying the areas where adequate sampling should be done.
Endometrial Hyperplasia ; Hysteroscopy

Background: Pelvic ultrasonography is currently not recommended as a screening tool for endometrial cancer, particularly in asymptomatic women; however, its use for other indications such as pelvic masses has led to incidental findings of thickened endometrium in post menopausal women. Objectives: The aim of the study is to evaluate the clinical utility of endometrial ultrasound in asymptomatic Filipino postmenopausal women and to provide a threshold for invasive endometrial sampling. Methodology: A cohort of postmenopausal women (aged ?50 years) who underwent pelvic ultrasonography at a tertiary hospital for indications other than vaginal bleeding was retrospectively evaluated. Women were included if they had an endometrial lining of at least 5 mm and had an endometrial biopsy. Receiver operating characteristic (ROC) analysis was used to determine the endometrial thickness threshold for which endometrial thickness is able to correctly differentiate benign endometrial pathology from endometrial hyperplasia and carcinoma. Results: Out of 90 women included in the study, carcinoma was identified in 3 (3.33%) and hyperplasia was noted in 4 (4.44%). The most common histopathology noted was: endometrial polyp (35.56%), atrophic endometrium (30%) and benign endometrial tissues (18.98%). The calculated area under ROC curve was 54.39% (95% CI 34.38-79.41%), which indicates the inability of endometrial thickness to differentiate benign endometrium from endometrial carcinoma or hyperplasia in asymptomatic women with an incidentally found thickened endometrium. Conclusion Based on the results of the study, endometrial thickness alone cannot be used as basis for deciding whether to perform endometrial sampling, there is no endometrial thickness threshold for which the endometrial hyperplasia and carcinoma can be correctly identified. The decision to perform an endometrial biopsy should be done on a case to case basis. In the absence of a high index of suspicion for endometrial hyperplasia and carcinoma even in the presence of thickened endometrium, endometrial sampling is unnecessary.
Endometrial Neoplasms ; Endometrial Hyperplasia ; Incidental Findings

Background: Metformin has been studied for its anti-proliferative effects on endometrial cells, and it is hypothesized to have a synergistic effect with progestin therapy in suppressing endometrial cell proliferation. This systematic review and meta-analysis aimed to determine the efficacy of adjunctive metformin in the clinical regression of endometrial hyperplasia and early-stage endometrial carcinoma. Methodology: This meta-analysis followed the Cochrane methodology and adhered to the PRISMA 2020 guidelines. Randomized controlled trials (RCTs) were included if they enrolled reproductive-aged women with endometrial hyperplasia (with and without atypia) and endometrial carcinoma who were treated with progestin and metformin. The primary outcome was the complete response rate at 12-16 weeks, and secondary outcomes included relapse rate, clinical pregnancy rate, and live birth rate. Odds ratios (ORs) and 95% confidence intervals (CIs) were used for dichotomous data. Results: Six RCTs were included. The addition of metformin to progestin therapy may increase the complete response rate of endometrial hyperplasia without atypia (OR 5.12, 95% CI 1.17 to 22.41; n=102) and live birth rates (OR 2.51, 95% CI 1.34 to 4.69; n=188) compared to progestin therapy alone, but the certainty of the evidence is low. Metformin did not have a significant effect on the clinical response of endometrial hyperplasia with atypia and endometrial carcinoma, relapse rates, and clinical pregnancy rates. Conclusion Current evidence is uncertain on the potential benefit of metformin with progestin in endometrial hyperplasia and carcinoma. Future high-quality randomized controlled trials with larger sample sizes and longer follow-up periods are needed to support practice recommendations.
Endometrial Hyperplasia ; Endometrial Neoplasms ; Metformin ; Progesterone

OBJECTIVE: The purpose of this study is to compare the expression rate of cyclooxygenase-2 (COX-2), p53 in endometrial hyperplasia, endometrial cancer and normal endometrium and to correlate COX-2 with the clinicopathological factors and p53 in endometrial cancer. METHODS: Immunohistochemical stain of COX-2, p53 was performed on samples from a series of 19 cases of normal proliferative endometrium, 20 cases of complex endometrial hyperplasia and 19 cases of endometrial cancer. And then we analyzed the expression of COX-2 correlated the findings with clinicopathological factors and p53. Expression of COX-2 was scored according to the proportion of positive-staining cells: negative, no staining; 1+, <10%; 2+, 10-50%; 3+, >50. For p53 overexpression, when there were at least 10% of tumor cells stained, it was considered as positive. RESULTS: Overexpression of COX-2 (> or =2+) was seen in 5 (26.3%) of the endometrial cancers, 6 (30%) of the complex endometrial hyperplasia, and 4 (21.1%) of the normal endometria. The expression rates of COX-2 in endometrial cancer, hyperplasia and normal endometrium were not different statistically significant (p=0.93). COX-2 was not correlated with clinicopathological factors but correlated with p53 significantly (p=0.021). CONCLUSION: In this study, the immunohistochemical analysis showed no difference statistically in COX-2 expression between endometrial cancer and hyperplasia compared to normal endometria. COX-2 was significantly correlated with p53. This finding may represent that tumor suppressor p53 upregulates COX-2 expression.
Cyclooxygenase 2* ; Endometrial Hyperplasia* ; Endometrial Neoplasms* ; Endometrium* ; Female ; Hyperplasia

OBJECTIVE: To compare the expression of CD44 V6 in normal endometrium, endometrial hyperplasia, and endometrial cancer and to evaluate CD44 variant 6 for prognostic marker. METHODS: Seventy six endometrial samples at Korea University Anam Hospital from 1991 to 2001 (37 normal endometrium, 15 endometrial hyperplasia, and 24 endometrial cancer) were immunohistochemically investigated for the expression of variant 6, isoform of CD44. Immunoreactivity scores were generated by multiplication of the values for the immunopositivity and immunointensity. RESULTS: CD44 V6 was detected in 19/37 cases of normal endometrium (only secretory phase), 1/15 endometrial hyperplasia, and 24/24 endometrial cancer. Immunoreactivity was higher in well differentiated endometrial cancer, while no association was noted with cancer stage. CONCLUSION: CD44 V6 expression in normal endometrium is observed in the secretory phase. Detection of expression of CD44 V6 may be useful for the early diagnosis of endometrial cancer and may be an useful prognostic marker.
Early Diagnosis ; Endometrial Hyperplasia* ; Endometrial Neoplasms* ; Endometrium* ; Female ; Korea

Endometrial adenocarcinoma in a double uterus has rarely been reported.We had a very rare case of double uterus with endometrial adenocarcinoma involving onehemiuterus and endometrial hyperplasia involving another hemiuterus. By report this case, wewant to share our experiance. The abnomal anatomy of the uterine cavities could have madeadequate biopsy difficult and endometrial cancer is clinically suspected but histology fails toconfirm the diagnosis.
Adenocarcinoma* ; Biopsy ; Diagnosis ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Female ; Uterus*