Recent advances in the management of postmenopausal women with non-atypical endometrial hyperplasia

Abstract

Non-atypical endometrial hyperplasia is a benign disease without significant somatic genetic changes. Postmenopausal women with non-atypical endometrial hyperplasia have a significant risk of progression to endometrial cancer and persistent endometrial hyperplasia. Most cases of atypical endometrial hyperplasia in postmenopausal women are treated surgically, including hysterectomy. At present, the treatment of postmenopausal women with non-atypical endometrial hyperplasia is still controversial. Correct and timely diagnosis and treatment are of great significance to prevent progression of the lesion. This study mainly provides an updated synthesis of the literature that investigates the etiology, diagnosis and treatment of postmenopausal women with non-atypical endometrial hyperplasia. As of December 2022, a literature search related to postmenopausal non-atypical endometrial hyperplasia was conducted on the PubMed database. For most postmenopausal patients with non-atypical endometrial hyperplasia, regular re-examination should be performed during conservative treatment. For postmenopausal patients with endometrial cancer risk factors, persistent non-atypical endometrial hyperplasia or progesterone contraindications, hysterectomy and bilateral salpingo-oophorectomy should be the first choice.

摘要

子宫内膜非典型增生是一种良性疾病, 无明显的体细胞遗传变化。患有子宫内膜非典型增生的绝经后女性有发展为子宫内膜癌和持续性子宫内膜增生的显著风险。大多数绝经后女性子宫内膜非典型增生的病例都是通过手术治疗的, 包括子宫切除术。目前, 绝经后女性子宫内膜非典型增生的治疗仍存在争议。正确及时的诊断和治疗对防止病变进展具有重要意义。本研究主要对绝经后女性子宫内膜非典型增生的病因、诊断和治疗进行了综述。截至2022年12月, 在PubMed数据库上进行了一项与绝经后子宫内膜非典型增生相关的文献检索。对于大多数绝经后子宫内膜非典型增生的患者, 在保守治疗期间应定期复查。对于有子宫内膜癌危险因素的绝经后患者, 子宫内膜持续性非典型增生或有孕激素禁忌证、应首选子宫切除术和双侧输卵管-卵巢切除术。

Keywords:

• Non-atypical endometrial hyperplasia
• endometrial intraepithelial neoplasia
• postmenopause
• progesterone therapy