07 aug. 2008 NEOPLAZIA ENDOMETRIALA INTRAEPITELIALA: O ABORDARE DIFERITA A HIPERPLAZIEI ENDOMETRIALE
R. Bohîltea*, V. Ancãr**
*Clinica Obstetricã si Ginecologie Elias UMF “Carol Davila”, Bucuresti
**Clinica de Obstetricã Ginecologie “Sf. Pantelimon”, UMF “ Carol Davila”, Bucuresti
Rezumat
Hiperplazia endometrialã este o afectiune frecventã al cãrei risc global de progresie spre cancer este apreciat de 5-10% cu variatii individuale importante în functie de paternal histologic. Relevanta diagnosticului se repercutã asupra rezultatelor optiunii terapeutice care poate devein inadecvatã în raport cu riscul oncologic real.
Noua clasificare EIN are la bazã studii integrate de morfologie, geneticã molecularã, biologie celularã si morfometrie cu caracter prognostic, scorul D dovedindu-se un marker cu sensibilitate, specificitate si valoare predictivã pentru cancerul endometrial superioarã clasificãrii OMS actual funtionalã si oferind o directionare adecvatã a conduitei terapeutice.
Abstract
Endometrial hyperplasia is a common disease: the overall risk of progression to cancer is 5-10% but this may vary substantially between individual patients according to the histological pattern. Unreliable diagnosis of hyperplasia translates into inappropriate treatment, either as a result of the undertreatment of high risk lesions or the overtreatment of low risk lesions.
The new EIN classification is based on integrated morphological, genetic molecular, cell biological and prognostic morphometrical studies; the D-score in endometrial hyperplasia’s is a more sensitive and specific marker for cancer prediction than WHO classification and it is a clinically relevant diagnosis that is intended to direct treatment.