[Clinicopathological analysis in cases with glandular and atypical glandular hyperplasia treated with gestagens]

Many of the cases with endometrial adenocarcinoma of the endometrium are proceeded of glandular and atypical glandular hyperplasia with different risk of progression to neoplasia. Two hundred and eighty cases with glandular and atypical glandular hyperplasia were examined in order to assess the risk of their progression into endometrial cancer. The hyperplasias were evaluated separately for their likelihood of progression to cancer in patients treated and not treated with progestogen therapy. In all cases a fractional re-curreting was performed in order to evaluate the stage of the disease. The leading symptom was the vaginal bleeding in 70% of the cases in the postmenopause. Seventy eight percent of the patients were with obesity (BMI > 30 mg/m2), twenty six percent were with exogenous use of estrogens. 4% of the cases with glandular hyperplasia progressed into cancer and in 13% into atypical grandular hyperplasia. 55% of the atypical glandular hyperplasias progressed into cancers. In the cases with progestogen treatment 70% of the cases showed remission confirmed by re-curetting compared with 23% of the cases without hormonal treatment. The grandular hyperplasia without atypia responded to hormonal therapy. In the postmenopausal patients the atypical glandular hyperplasia should be treated with surgery--total hysterectomy.