CLINICAL, MORPHOLOGICAL, AND EPIDEMIOLOGICAL CHARACTERISTICS OF ENDOMETRIAL HYPERPLASTIC PROCESSES IN SUMY REGION

N. Tsyndrenko, A. Romaniuk, Yana R. Nikolayenko
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Abstract

Endometrial hyperplastic processes take an important place among the gynecological diseases in women of various ages and are one of the most common reasons for admission at inpatient gynecology departments. The urgency of the pathology is due to the significant prevalence of endometrial hyperplastic processes, high incidence of malignancy, prolonged relapsing course, and decreased reproductive function, since these diseases are one of the most common causes of infertility in women of childbearing age. The statistics related to the incidence of endometrial hyperplastic processes in Ukraine is not available. An analysis of case histories and medical records showed that in 40% of cases, endometrial hyperplastic processes were asymptomatic. In 60% of cases, the clinical manifestations of endometrial hyperplastic processes were menstrual disorders, such as dysmenorrhea, oligomenorrhea, menorrhagia, and metrorrhagia. In 30% of cases, endometrial hyperplastic processes were recurrent. The most common concomitant pathologies of the pelvic organs were uterine leiomyoma and endometriosis; the most common concomitant extragenital diseases were hypertension and obesity. Our study and data analysis showed that there is an increasing trend in the incidence of endometrial hyperplastic processes in Sumy region in 2011–2020. The maximum incidence was in 2016. A correlation was found between hyperplasia incidence and age. Thus, the largest number of non-atypical and atypical endometrial hyperplasia cases was observed in women aged 45–55 years. The lowest number of non-atypical endometrial hyperplasia cases was registered in women aged 66+, while atypical hyperplasia cases – in women under 30 years of age. Glandular polyps of the endometrium were most often diagnosed at the age of 31–44; the lowest number of these was found in women over 66 years. Most glandular-fibrous endometrial polyps were observed in women aged 45–55 years, while women under 30 presented with the fewest cases. Fibrous endometrial polyps were most common in older age groups – 66+; the lowest number of such endometrial polyps was found in women under 30 years. We attributed the decreased incidence of endometrial hyperplastic processes in 2020 to the quarantine measures introduced, which, as a consequence, led to the decreased number of diagnosed cases, since they are often asymptomatic.
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苏梅地区子宫内膜增生过程的临床、形态学和流行病学特征
子宫内膜增生性病变在各年龄段妇女的妇科疾病中占有重要地位,是妇科住院患者最常见的原因之一。由于这些疾病是育龄妇女不孕症的最常见原因之一,因此子宫内膜增生过程的显著流行、恶性肿瘤的高发病率、复发过程延长和生殖功能下降是病理学的紧迫性。与乌克兰子宫内膜增生性过程发生率相关的统计数据尚不清楚。对病例史和医疗记录的分析表明,在40%的病例中,子宫内膜增生过程是无症状的。60%的子宫内膜增生性病变临床表现为月经紊乱,如痛经、少经、月经过多、子宫出血。在30%的病例中,子宫内膜增生过程复发。盆腔器官最常见的伴发病变是子宫平滑肌瘤和子宫内膜异位症;最常见的伴随性外阴疾病是高血压和肥胖。我们的研究和数据分析表明,2011-2020年苏梅地区子宫内膜增生性病变的发病率呈上升趋势。发病率最高的年份是2016年。发现增生发生率与年龄有相关性。因此,45-55岁的女性是非典型和非典型子宫内膜增生病例最多。非典型子宫内膜增生病例在66岁以上的女性中最少,而非典型子宫内膜增生病例在30岁以下的女性中最少。子宫内膜腺性息肉最常见于31-44岁;在66岁以上的女性中,这一比例最低。大多数腺纤维性子宫内膜息肉发生在45-55岁的女性中,而30岁以下的女性病例最少。纤维性子宫内膜息肉最常见于66岁以上年龄组;这种子宫内膜息肉在30岁以下的女性中发病率最低。我们将2020年子宫内膜增生性病变的发病率下降归因于引入的隔离措施,这导致确诊病例数量减少,因为它们通常是无症状的。
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