Yusuf ÇAKMAK, Tufan ÖGE, Ece USLU, Duygu KAVAK CÖMERT, Özgür AYDIN TOSUN

ENDOMETRİAL HİPERPLAZİLİ HASTALARDA EŞ ZAMANLI ENDOMETRİAL KANSER GÖRÜLMESİNİN DEGERLENDİRİLMESİ;ÜÇÜNCÜ BASAMAK HASTANE OLARAK 10 YILLIK DENEYİMİMİZ

ÖZET Amaç: Cerrahi tedavi uygulanan endometrial hiperplazili hastalarda eş zamanlı endometrial kanser insidansını belirlemeyi amaçladık. Gereç ve yöntem: Çalışmamız retrospektif olarak dizayn edildi. 2007 - 2017 yılları arasında Eskişehir Osmangazi Üniversitesi (ESOGÜ) jinekolojik Onkoloji bölümünde endometrial biyopsi ile endometrial hiperplazi (EH) tanısı alan ve cerrahi tedavi uygulanan hastaların tıbbi kayıtları incelenerek çalışma oluşturuldu. Endometrial örnekleme sonucu endometrial hiperplazili 522 hastanın verileri değerlendirildi. 187 hasta medikal tedavi uygulandığı için, 35 hasta tıbbi kayıtları yetersiz olduğu için ve 15 hasta endometrial kanser şüphesi olduğu için çalışma dışı bırakıldı. Çalışmaya endometrial hiperplazili 285 hasta dahil edildi. Bulgular: Çalışmaya alınan 285 hastanın 64'ü (% 22.4) basit hiperplazi, 31'i (% 10.8) basit atipili hiperplazi, 72'si (% 25.2) kompleks hiperplazi ve 118'i (% 41.4) kompleks atipili hiperplazi idi. Histerektomi spesmenlerinin incelenmesiyle 84 (% 29.4) hastada endometrial patoloji izlenmezken , 36 hastada (% 12.6) endometrial kanser, 165 hastada (% 57.8) endometrial hiperplazi bulduk. Basit hiperplazide 1 (% 1,5) hastada endometrial kanser bulduk.Basit atipili hiperplazide 1 (% 3,2) hastada endometrial kanser tespit edildi. Kompleks hiperplazide 6 hastada (% 8.3) endometrial kanser vardı. Kopleks atipili hiperplazide 28 (% 23,7) hastada endometrial kanser tespit edildi. 2014 Dünya Sağlık Örgütü sınıflandırma sistemine göre, eş zamanlı endometrial kanser oranları atipili endometrial hiperplazide % 19.4, atipi olmayan endometrial hiperplazide % 5.1 olarak tespit edildi. Sonuç: Basit hiperplazide eşzamanlı endometrial kanser oranı% 5.1, bu oran kompleks hiperplazide % 8,3 olarak bulundu. Atipi olmayan endometrial hiperplazili hastaların tedavisinde medikal tedavi seçilecekse bu oranlar göz önünde bulundurulmalıdır.Endometrial hiperplazi yönetiminde endometrial kanser için tüm risk faktörlerinin detaylı değerlendirilmesi önerilir.

Anahtar Kelimeler:

Atipili endomertial hiperplaziler, Atipisiz endometrial hiperplazi, Endometrial kanser

EVALUATION OF CONCURRENT ENDOMETRİAL CANCSER İN PATİENTS WİTH ENDOMETRIAL HYPERPLASIA; 10 YEARS EXPERIENCE AS A TERTİARY CENTER

ABSTRACTObjective: we aimed to determine the incidence of simultaneous endometrial cancer in patients with endometrial hyperplasia who underwent surgical treatment.Material and method: Our study was designed retrospectively.The medical data of patients who was diagnosed endometrial hyperplasia(EH) by the endometrial biopsy and accepted surgical treatment were examined and collected between 2007 - 2017 at the gynecologic oncology depertmant of Eskişehir Osmangazi University(ESOGÜ). The data of 522 patients with endometrial hyperplasia as a result of endometrial sampling were evaluated. Due to 187 patients received medical treatment, 35 patients lacked medical data and 15 patients suspected endometrial CA were excluded from the study. A total of 285 patients with endometrial hyperplasia were included in the study.Result: Of the 285 patients included in the study, 64 (22.4%) were simple hyperplasia, 31 (10.8%) were simple atypia hyperplasia, 72 (25.2%) were complex hyperplasia and 118 (41.4%) were complex atypia hyperplasia. Endometrial hyperplasia could not be detected in 84 (29.4%) patients after a final pathology. We found endometrial cancer in 36 (12.6%) patients and endometrial hyperplasia in 165 (57.8%) patients. We found 1 (1.5%) patient EC in simple hyperplasia. EC was detected in 1 (3.2%) patient in SAH. 6 patients (8.3%) had EC in CH. 28 (23.7%) EC’s were detected in patients with CAH. According to the 2014 WHO classification system ,Concurrent endometrial cancer rates were determined as AEH 19.4% and EH without atypia was 5.1%. Conclusion: Concurrent EC ratio in simple hyperplasia was 5.1% this rate was found to be 8.3 % in CH. Management of patients with endometrial hyperplasia without atypia If medical treatment is to be chosen, these rates should be considered and it is recommended to consider all risk factors for EC.

Keywords:

Atypical endometrial hyperplasia, Simple endometrial hyperplasia, Endometrial cancer,

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