Predicting the risk of malignisation of endometrial hyperplasia in reproductive age
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 malignisation 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, adenomyosis, 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.