What we need to know about complex atypical endometrial hyperplasia

Do you know what complex atypical endometrial hyperplasia is? How much do you know about this disease? Hyperplasia is usually a prerequisite for cancer. We cannot ignore the harm it brings because this disease can seriously harm your body. Do you know the treatment of complex atypical endometrial hyperplasia? Let's take a look!

Atypical hyperplasia: It is a precancerous lesion with cellular atypia, cells of varying sizes, darkly stained nuclei, and no stromal infiltration. According to the degree of glandular epithelial hyperplasia, it is divided into three types: mild, moderate and severe.

(1) Mild atypical hyperplasia: mild atypical pattern of glandular epithelial cells.

(2) Moderate atypical hyperplasia: The aberrant morphology of glandular epithelial cells is more obvious.

(3) Severe atypical hyperplasia: The glandular epithelial cells show obvious abnormalities. The glands are bridged and share a common wall, with no interstitial infiltration. Atypical hyperplasia is a precancerous lesion, and 23% of them may develop into cancer after 11 years of follow-up. The canceration rates of mild, moderate and severe dysplasia are 15%, 24% and 45% respectively.

diagnosis

1. The diagnosis can be confirmed by histopathological examination of fractional curettage.

2. Ultrasound examination, especially vaginal ultrasound, showing obvious thickening of the endometrium ≥ 5 mm; as well as biopsy and pathological examination under direct vision of the hysteroscope are helpful for diagnosis and treatment. 1. Simple endometrial hyperplasia or complex hyperplasia is often treated with progesterone therapy, regular curettage and examination of the endometrium. 85% of the cases can be reversed by progesterone therapy; hysteroscopic endometrial resection can also be performed. Hysterectomy may be performed for perimenopausal patients or those who do not respond to conservative treatment.

Complex endometrial hyperplasia with severe atypical hyperplasia, local malignancy is considered, complex endometrial hyperplasia with glandular epithelial ciliated columnar metaplasia. Most of the curettage tissue showed simple hyperplasia, with small foci of complex hyperplasia and simple and complex hyperplastic glands accompanied by small foci of mild atypical hyperplasia. No intraepithelial lesions or malignant cells were found, thus excluding endometrial lesions. After the operation, I kept bleeding with a lot of blood clots and took medicine for about 60 days.

The cause of endometrial hyperplasia is mainly related to long-term estrogen stimulation. Endometrial hyperplasia is classified into simple hyperplasia, complex hyperplasia and atypical hyperplasia in histology. The proliferative lesions with morphological characteristics of atypical changes in cells are called atypical endometrial hyperplasia, which are divided into three degrees: mild, moderate and severe according to the degree of the lesion. Both simple hyperplasia and complex hyperplasia have no cell atypia, but the degree of change in glandular structure is different. After drug treatment, the endometrial lesions of patients with endometrial hyperplasia become lighter or return to normal, and even pregnancy can be achieved, but there is still a possibility of recurrence after drug withdrawal or after delivery. This tendency of recurrence may be related to the failure to fundamentally correct the factors that cause high estrogen levels in the human body. In short, most patients with endometrial hyperplasia have a good prognosis after active drug treatment. If atypical endometrial hyperplasia occurs in women before and after menopause, the potential rate of malignant lesions is high. Patients with moderate to severe atypical hyperplasia should be closely followed up during treatment. If a few patients are found to have poor efficacy, hysterectomy can be performed in time to avoid cancer.

After learning about these conditions related to complex atypical endometrial hyperplasia, you now have a deeper understanding of this disease. If so, you need to prescribe the right medicine for your condition, receive the safest treatment, do the most formal examinations, and then proceed with treatment. We cannot take this disease lightly, and I hope you all stay healthy!