Prediction of endometrial carcinogenesis probability while diagnosed as atypical endometrial hyperplasia: a new risk...

To establish a risk model for predicting the probability of endometrial carcinogenesis while diagnosed as AEH preoperatively.

149 patients with AEH diagnosed by D&C specimens or hysteroscopy undergoing total hysterectomy were enrolled in this retrospective study. Patients were divided into two groups: 51 cases in AEH to AEH group and 98 cases in AEH to EC group. The clinical pathological characteristics were compared between the two groups. With the use of ROC curves, cutoff values of age, CA199, CA125 and uterine height were determined. The relationships of these evaluators with endometrial carcinogenesis were investigated by multivariate analysis with a logistic regression model.

65.8% (98/149) of preoperative AEH patients become EC after confirmed by paraffin hysterectomy specimens. The cutoff values were 51.5 years of age, 14.06U/ml of CA199, 14.30U/ml of CA125 and 45mm of uterine height, respectively. Logistic regression analysis demonstrated age (OR=0.58, 95% confidence interval [95%CI]: 0.08-3.94), CA199 (OR=7.27, 95%CI: 1.43-36.92), CA125 (OR=13.97, 95%CI: 2.49-78.37), uterine height (OR=0.49, 95%CI: 0.08-3.08) and abnormal uterine bleeding (OR=4.27, 95%CI: 0.53-34.52) were associated with endometrial carcinogenesis. However, only CA199 (p=0.017) and CA125 (p=0.003) revealed significant differences. Therefore, when entered into the risk model, CA199≥14.06U/ml and CA125≥14.30U/ml were considered as cogent predictors of endometrial carcinogenesis.

This risk model may well predict the probability of endometrial carcinogenesis when preoperatively diagnosed as AEH.