Background and precancerous diseases of the endometrium during pregnancy
A. L. Chernyshova,
O. S. Dil,
A. A. Chernyakov,
Yu. M. Truschuk,
V. A. Antipov,
Ya. I. Arkhipova,
A. Е. Chernyshova https://doi.org/10.17650/1994-4098-2024-16-2-134-143
Abstract
The article presents an analysis of the current state of the problem of background and precancerous diseases of the endometrium. The issues of etiology and pathogenesis of these conditions are reflected, as well as the features and difficulties of diagnosis, treatment and course in patients with pregnancy are presented. The experience of the Tomsk Oncology Research Institute in the treatment of this pathology is presented, as well as clinical cases that clearly demonstrate the possibility of successful treatment of both endometrioid intraepithelial neoplasia and initial uterine body cancer. It should be noted that the results of treatment of this category of patients are quite good, as well as the expediency of careful dynamic monitoring of this category of patients and the possibility of collegial decision-making in determining treatment tactics at all stages of therapy.
Supporting agencies: The work was performed without external funding.
About the Authors
A. L. Chernyshova
E.N. Meshalkin National Medical Research Center, Ministry of Health of Russia; Oncology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Competing Interests:
Russian Federation
Alena Leonidovna Chernyshova
15 Rechkunovskaya St., Novosibirsk 630055; 5 Kooperativnyy Pereulok, Tomsk 634009
Competing Interests:
The authors declare no conflict of interest.
O. S. Dil
E.N. Meshalkin National Medical Research Center, Ministry of Health of Russia; Oncology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Competing Interests:
Russian Federation
15 Rechkunovskaya St., Novosibirsk 630055; 5 Kooperativnyy Pereulok, Tomsk 634009
Competing Interests:
The authors declare no conflict of interest.
A. A. Chernyakov
E.N. Meshalkin National Medical Research Center, Ministry of Health of Russia; Oncology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Competing Interests:
Russian Federation
Аleksandr Alekseecich Chernyakov
15 Rechkunovskaya St., Novosibirsk 630055; 5 Kooperativnyy Pereulok, Tomsk 634009
Competing Interests:
The authors declare no conflict of interest.
Yu. M. Truschuk
Oncology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Competing Interests:
Russian Federation
5 Kooperativnyy Pereulok, Tomsk 634009
Competing Interests:
The authors declare no conflict of interest.
V. A. Antipov
E.N. Meshalkin National Medical Research Center, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
15 Rechkunovskaya St., Novosibirsk 630055
Competing Interests:
The authors declare no conflict of interest.
Ya. I. Arkhipova
Siberian State Medical University, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
2 Moskovskiy Trakt, Tomsk 634050
Competing Interests:
The authors declare no conflict of interest.
A. Е. Chernyshova
Saint Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
7–9 Universitetskaya Naberezhnaya, Saint Petersburg 199034
Competing Interests:
The authors declare no conflict of interest.
References
1. Duska L.R., Garrett A., Rueda B.R. et al. Endometrial cancer in women 40 years old or younger. Gynecol Oncol 2001;83(2): 388–93. DOI: 10.1006/gyno.2001.6434
2. Cancer Stat Facts: Uterine Cancer. Available at: https://seer.cancer.gov/statfacts/html/corp.html.
3. State of oncological care in Russia in 2021. Eds.: А.D. Kaprin, V.V. Starinskiy, A.O. Shachzadova. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMITS radiologii” Minzdrava Rossii, 2022. 239 p. (In Russ.).
4. Setiawan V.W., Yang H., Pike M. et al. Type I and II endometrial cancers: Have they different risk factors? J Clin Oncol 2013;31(20):2607–18. DOI: 10.1200/JCO.2012.48.2596
5. Brinton L.A., Felix A.S., McMeekin D.S. et al. Etiologic heterogeneity in endometrial cancer: Evidence from a Gynecologic Oncology Group trial. Gynecol Oncol 2013;129(2):277–84. DOI: 10.1016/j.ygyno.2013.02.023
6. Nees L.K., Heublein S., Steinmacher S. et al. Endometrial hyperplasia as a risk factor of endometrial cancer. Arch Gynecol Obstet 2022;306(2):407–21. DOI: 10.1007/s00404-021-06380-5
7. Gunderson C.C., Fader A.N., Carson K.A., Bristow R.E. Oncologic and reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 adenocarcinoma: A systematic review. Gynecol Oncol 2012;125(2):477–82. DOI: 10.1016/j.ygyno.2012.01.003
8. Kurman R.J., Kaminski P.F., Norris H.J. The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients. Cancer 1985;56:403–12. DOI: 1002/1097-0142(19850715)56:23.0.co;2-x
9. Lacey J.V.Jr., Chia V.M., Rush B.B. et al. Incidence rates of endometrial hyperplasia, endometrial cancer and hysterectomy from 1980 to 2003 within a large prepaid health plan. Int J Cancer 2012;131:1921–9. DOI: 1002/ijc.27457
10. Lacey J.V., Sherman M.E., Rush B.B. et al. Absolute risk of endometrial carcinoma during 20-year follow-up among women with endometrial hyperplasia. J Clin Oncol 2010;28(5):788–92.
11. Trimble C.L., Method M., Leitao M. et al. Management of endometrial precancers. Obstet Gynecol 2012 ;120(5):1160–75. DOI: 10.1097/aog.0b013e31826bb121
12. Reed S.D., Voigt L.F., Newton K.M. et al. Progestin therapy of complex endometrial hyperplasia with and without atypia. Obstet Gynecol 2009;113(3):655–62.
13. Montz F.J., Bristow R.E., Bovicelli A. et al. Intrauterine progesterone treatment of early endometrial cancer. Am J Obstet Gynecol 2002;186(4):651–7.
14. Dhar K.K., Needhi Rajan T., Koslowski M., Woolas R.P. Is levonorgestrel intrauterine system effective for treatment of early endometrial cancer? Report of four cases and review of the literature. Gynecol Oncol 2005;97(3):924–7.
15. McCawley G.M., Ferriss J.S., Geffel D. et al. Cancer in obese women: Potential protective impact of bariatric surgery. J Am Coll Surg 2009;208(6):1093–8.
16. Alonso S., Castellanos T., Lapuente F., Chiva L. Hysteroscopic surgery for conservative management in endometrial cancer: a review of the literature. Ecancermedicalscience 2015;9:505.
17. Wildemeersch D., Dhont M. Treatment of nonatypical and atypical endometrial hyperplasia with a levonorgestrel-releasing intrauterine system. Am J Obstet Gynecol 2003;188(5):1297–8.
18. Gunderson C.C., Fader A.N., Carson K.A., Bristow R.E. Oncologic and reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 adenocarcinoma: A systematic review. Gynecol Oncol 2012;125(2):477–82. DOI: 10.1016/j.ygyno.2012.01.003
19. Chernysheva A.L., Kolomiets L.A., Kritskaya N.G., Sukhodolo I.V. Prognostic criteria of oncological risk in endometrial proliferative processes. Rossiyskiy onkologicheskiy zhurnal = Russian Journal of Oncology 2005;(3):22–5. (In Russ.).
20. Pashov A.I., Tskhay V.B., Ionouchene S.V. The combined GnRHagonist and intrauterine levonorgestrel-releasing system treatment of complicated atypical hyperplasia and endometrial cancer: A pilot study. Gynecol Endocrinol 2012;28:559–61. DOI: 10.3109/09513590.2011.649813
21. Novikova O.V., Nosov V.B., Panov V.A. et al. Live births and maintenance with levonorgestrel IUD improve disease-free survival after fertility-sparing treatment of atypical hyperplasia and early endometrial cancer. Gynecol Oncol 2021;161:152–9. DOI: 10.1016/j.ygyno.2021.01.001
22. Chae-Kim J., Garg G., Gavrilova-Jordan L. et al. Outcomes of women treated with progestin and metformin for atypical endometrial hyperplasia and early endometrial cancer: A systematic review and meta-analysis. Int J Gynecol Cancer 2021;31:1499–505. DOI: 10.1136/ijgc-2021-002699
23. Cho H.H., Kim M.R., Kim J.H. Outpatient multimodality management of large submucosal myomas using transvaginal radiofrequency myolysis. J Minim Invasive Gynecol 2014;21: 1049–54. DOI: 10.1016/j.jmig.2014.04.019.
24. Prodromidou A., Lekka S., Fotiou A. et al. The evolving role of targeted metformin administration for the prevention and treatment of endometrial cancer: A systematic review and meta-analysis of randomized controlled trials. J Gynecol Obstet Hum Reprod 2021;50:102164. DOI: 10.1016/j.jogoh.2021.102164.
25. Matsuo K., Mandelbaum R.S., Ciccone M. et al. Route-Specific association of progestin therapy and concurrent metformin use in obese women with complex atypical hyperplasia. Int J Gynecol Cancer 2020;30:1–9. DOI: 10.1136/ijgc-2020-001362
26. Abu Hashim H., Ghayaty E., El Rakhawy M. Levonorgestrelreleasing intrauterine system vs oral progestins for non-atypical endometrial hyperplasia: A systematic review and metaanalysis of randomized trials. Am J Obstet Gynecol 2015;213(4):469–78.
27. Fan Z., Li H., Hu R. et al. Fertility-preserving treatment in young women with grade 1 presumed stage Ia endometrial adenocarcinoma: A meta-analysis. Int J Gynecol Cancer 2018;28:385– 93. DOI: 10.1097/IGC.0000000000001164
28. Wei J., Zhang W., Feng L., Gao W. Comparison of fertility-sparing treatments in patients with early endometrial cancer and atypical complex hyperplasia: A meta-analysis and systematic review. Medicine 2017;96:e8034. DOI: 10.1097/MD.0000000000008034
29. Chernyshova A.L., Kolomiets L.A., Sinilkin I.G. et al. Optimization of approaches to choosing the volume of surgical treatment in patients with cervical cancer (the role of sentinel lymph node research). Voprosy onkologii = Oncology Issues 2016;62(6):807–11. (In Russ.).
30. Yunusova N.V., Kondakova I.V., Kolomiets L.A. et al. Molecular targets for the therapy of cancer associated with metabolic syndrome (transcription and growth factors). Asia-Pacific J Clin Oncol 2018;14(3):134–40. DOI: 10.1111/ajco.12780
31. Kukharev D.Yu., Savitskaya V.M., Kostrova E.V. et al. Features of the course of pregnancy with cervical dysplasia. Identification of significant risk factors. Molodoy uchenyy = Young Scientist 2018;14(200):133, 134. Available at: https://moluch.ru/archive/200/49200/. (In Russ.).
32. Suchonska B., Gajewska M., Madej A., Wielgoś M. Cervical intraepithelial neoplasia during pregnancy. Indian J Cancer 2020;57(1):31–5. DOI: 10.4103/ijc.IJC_403_18
33. Korolenkova L.I., Bryuzgin V.V., Bryuzgin V.V. Severe cervical intraepithelial neoplasia (CIN 2–3/pre-invasive cancer) and cervical microcarcinoma in pregnant women. Akusherstvo i ginekologiya = Obstetrics and Gynecology 2011;(5):68–73. (In Russ.).
34. Tirone N.R., Campos C.G., Ferreira K.J.A. et al. Pathways of IFN-alpha activation in patients with cervical intraepithelial neoplasia (CIN). Rev Bras Ginecol Obstet 2021;43(9):682–9. DOI: 10.1055/s-0041-1735301
35. Yakovleva O.V., Glukhova T.N., Rogozhina I.E., Skupova I.N. Pregnancy and cervical intraepithelial neoplasia of the cervix (review). Saratovskiy nauchno-meditsinskiy zhurnal = Saratov Scientific and Medical Journal 2019;15(1):19–23. (In Russ.).
Review
For citations:
Chernyshova A.L., Dil O.S., Chernyakov A.A., Truschuk Yu.M., Antipov V.A., Arkhipova Ya.I., Chernyshova A.Е. Background and precancerous diseases of the endometrium during pregnancy. Tumors of female reproductive system. 2024;20(2):134-143. (In Russ.) https://doi.org/10.17650/1994-4098-2024-16-2-134-143
Views:
308
Email this article 