Hiperplasia endometrial: una revisión narrativa sobre su patogénesis, factores de riesgo y diagnóstico.
Endometrial hyperplasia: a narrative review on its pathogenesis, risk factors and diagnosis.
Resumen
La hiperplasia endometrial con o sin atipia, es un diagnóstico ginecológico común y un precursor del carcinoma endometrial. Durante los años reproductivos, el riesgo de presentar una hiperplasia endometrial está relacionado con los trastornos ovulatorios. En la menopausia y posmenopausia, la hiperplasia endometrial está asociada con factores como la obesidad, la terapia de reemplazo de estrógeno y otros. El objetivo de este estudio narrativo fue revisar y analizar la patogenia, los factores de riesgo y los diferentes métodos de diagnóstico de la hiperplasia endometrial. Se revisaron los años comprendidos entre 1970 y noviembre de 2024 en la bibliografía latinoamericana e internacional, usando los sitios electrónicos como Pub-Med, Google Scholar, Springer, The Cochrane Library, Embase, Scielo, Imbiomed-L, Redalyc y Latindex, entre otros.
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Sobczuk K, Sobczuk A. New classification system of endometrial hyperplasia WHO 2014 and its clinical implications. Prz Menopauzalny. 2017;16(3):107-111. doi: 10.5114/pm.2017.70589.
Montgomery BE, Daum GS, Dunton CJ. Endometrial hyperplasia: a review. Obstet Gynecol Surv. 2004;59(5):368-378. doi: 10.1097/00006254-200405000-00025.
Höhn AK, Brambs CE, Hiller GGR, May D, Schmoeckel E, Horn LC. 2020 WHO Classification of Female Genital Tumors. Geburtshilfe Frauenheilkd. 2021;81(10):1145-1153. doi: 10.1055/a-1545-4279.
Ring KL, Mills AM, Modesitt SC. Endometrial Hyperplasia. Obstet Gynecol. 2022;140(6):1061-1075. doi: 10.1097/AO G.0000000000004989.
Ricci E, Moroni S, Parazzini F, Surace M, Benzi G, Salerio B, Polverino G, La Vecchia C. Risk factors for endometrial hyperplasia: results from a case-control study. Int J Gynecol Cancer. 2002;12(3):257-260. doi: 10.1046/j.1525-1438.2002.01105x.
Armstrong AJ, Hurd WW, Elguero S, Barker NM, Zanotti KM. Diagnosis and management of endometrial hyperplasia. J Minim Invasive Gynecol. 2012;19(5):562- 571. doi: 10.1016/j.jmig.2012.05.009.
Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K, Voigt LF, Weiss NS. Incidence of endometrial hyperplasia. Am J Obstet Gynecol. 2009;200(6):678. doi: 10.1016/j.ajog.2009.02.032.
Natarajan P, Vinturache A, Hutson R, Nugent D, Broadhead T. The value of MRI in management of endometrial hyperplasia with atypia. World J Surg Oncol. 2020 10;18(1):34. doi: 10.1186/s12957-020-1811-5.
Whitaker L, Critchley HO. Abnormal Uterine Bleeding. Best Pract Res Clin Obstet Gynaecol. 2016;34:54-65. doi: 10.1016/j.bpobgyn.2015.11.012.
Corpus uterei. Cancer Today. Globocan 2022 International Agency for Cancer Research. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefind-mkaj/https://gco.iarc.who.int/media/globocan/factsheets/cancers/24-corpus-uteri-fact-sheet.pdf. Revisado en junio 11, 2024.
Endometrial cancer statistics. World Cancer Research Fund International. Disponible en: https://www.wcrf.org/ cancer-trends/endometrial-cancer- statistics/#:~:text=There%20were%20420%2C368%20new%20cases%20of%20endometrial%20cancer%20in%202022. Revisado en junio 11, 2024.
Estadísticas importantes sobre el cáncer de endometrio. American Cancer Society. Disponible en: https://www.cancer.org/es/cancer/tipos/cancer-deendometrio/acerca/estadisticas-clave.html. Revisado en septiembre 09, 2024.
Siegel RL, Miller KD, Wagle NS, Jemal Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48. doi: 10.3322/ caac.21763. PMID: 36633525.
National Cancer Institute Surveillance, Epidemiology, and End Results Program. Cancer stat facts: uterine cancer. Disponible en: https://seer.cancer.gov/statfacts/html/corp.html. Revisado en noviembre 6, 2023.
Coulam CB, Annegers JF, Kranz JS. Chronic anovulation syndrome and associated neoplasia. Obstet Gynecol. 1983;61(4):403-407. PMID: 6828267.
Göl K, Saraçoğlu F, Ekici A, Sahin I. Endometrial patterns and endocrinologic characteristics of asymptomatic menopausal women. Gynecol Endocrinol. 2001;15(1):63-67. PMID: 11293927.
Tsujimoto Y, Finger LR, Yunis J, Nowell PC, Croce CM. Cloning of the chromosome breakpoint of neoplastic B cells with the t(14;18) chromosome translocation. Science. 1984 30; 226 (4678):1097-1099.doi: 10.1126/science.6093263.
Cleary ML, Sklar J. Nucleotide sequence of a t (14;18) chromosomal breakpoint in follicular lymphoma and demonstration of a breakpoint-cluster region near a transcriptionally active locus on chromosome 18. Proc Natl Acad Sci U S A. 1985;82 (21):7439-7443. doi: 10.1073/pnas.82.21.7439.
Nuñez G, London L, Hockenbery D, Alexander M, McKearn JP, Korsmeyer SJ. Deregulated Bcl-2 gene expression selectively prolongs survival of growth factor-deprived hemopoietic cell lines. J Immunol. 1990;144 (9):3602-3610. PMID: 2184193.
Gompel A, Sabourin JC, Martin A, Yaneva H, Audouin J, Decroix Y, Poitout P. Bcl-2 expression in normal endometrium during the menstrual cycle. Am J Pathol. 1994;144 (6):1195-1202. PMID: 8203460; PMCID: PMC1887458.
Otsuki Y, Misaki O, Sugimoto O, Ito Y, Tsujimoto Y, Akao Y. Cyclic bcl-2 gene expression in human uterine endometrium during menstrual cycle. Lancet. 1994;344 (8914):28-29. doi: 10.1016/s0140-6736(94)91051-0.
Hopwood D, Levison DA. Atrophy and apoptosis in the cyclical human endometrium. J Pathol. 1976; 119 (3):159-66. doi: 10.1002/path.1711190305. PMID: 956955.
Niemann TH, Trgovac TL, McGaughy VR, Vaccarello L. bcl-2 expression in endometrial hyperplasia and carcinoma. Gynecol Oncol. 199; 63 (3):318-322. doi: 10.1006/gyno.1996.0329. PMID: 8946865.
Wang S, Pudney J, Song J, Mor G, Schwartz PE, Zheng W. Mechanisms involved in the evolution of progestin resistance in human endometrial hyperplasia--precursor of endometrial cancer. Gynecol Oncol. 2003;88 (2):108-117. doi: 10.1016/s0090-8258(02)00008-2.
Maruo T, Laoag-Fernandez JB, Pakarinen P, Murakoshi H, Spitz IM, Johansson E. Effects of the levonorgestrel-releasing intrauterine system on proliferation and apoptosis in the endometrium. Hum Reprod. 2001; 16 (10):2103-2108. doi:10.1093/humrep/16.10.2103.
Chandra V, Kim JJ, Benbrook DM, Dwivedi A, Rai R. Therapeutic options for management of endometrial hyperplasia. J Gynecol Oncol. 2016;27 (1): e8. doi: 10.3802/jgo.2016.27.e8.
Ronnett BM, Kurman RJ. Precursor lesions of endometrial carcinoma. In: Kurman RJ, ed. Blaustein’s Pathology of the Female Genital Tract, 5th ed. New York: Springer-Verlag, 2002: 467–500.
Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients. Cancer. 1985;56(2):403-412. doi: 10.1002/1097-0142(19850715)56: 2<403::aid-cncr2820560233>3.0.co;2-x.
Terakawa N, Kigawa J, Taketani Y, Yoshikawa H, Yajima A, Noda K, Okada H, Kato J, Yakushiji M, Tanizawa O, Fujimoto S, Nozawa S, Takahashi T, Hasumi K, Furuhashi N, Aono T, Sakamoto A, Furusato M. The behavior of endometrial hyperplasia: a prospective study. Endometrial Hyperplasia Study Group. J Obstet Gynaecol Res. 1997;23(3):223-230. doi: 10.1111/j.1447-0756.1997.tb00836.x.
Bernstein S. A visual guide to uterine papillary serous carcinoma. Disponible en: https://www.webmd.com/cancer/cervical- cancer/ss/slideshow-uterine-papillar y serous-carcinoma. Revisado en: Marzo 14, 2024.
Bernstein L. The risk of breast, endometrial and ovarian cancer in users of hormonal preparations. Basic Clin Pharmacol Toxicol. 2006;98(3):288-296. doi: 10.1111/j.1742-7843.2006.pto_277.x.
WHO Classification of Tumours of Female Reproductive Organs. WHO Classification of Tumours, 4th Edition. 2024. Volume 6. Edited by Kurman RJ, Carcangiu ML, Herrington CS, Young RH.
Bacon JL. Abnormal Uterine Bleeding: Current Classification and Clinical Management. Obstet Gynecol Clin North Am. 2017;44(2):179-193. doi: 10.1016/j. ogc.2017.02.012.
Opolskiene G, Sladkevicius P, Valentin L. Prediction of endometrial malignancy in women with postmenopausal bleeding and sonographic endometrial thickness ≥ 4.5 mm. Ultrasound Obstet Gynecol. 2011;37(2):232-240. doi: 10.1002/uog.8871.
MacDonald PC, Edman CD, Hemsell DL, Porter JC, Siiteri PK. Effect of obesity on conversion of plasma androstenedione to estrone in postmenopausal women with and without endometrial cancer. Am J Obstet Gynecol. 1978;130 (4):448-455. doi: 10.1016/0002-9378(78)90287-9.
Kaye SA, Folsom AR, Soler JT, Prineas RJ, Potter JD. Associations of body mass and fat distribution with sex hormone concentrations in postmenopausal women. Int J Epidemiol. 1991;20 (1):151-156. doi: 10.1093/ije/20.1.151.
Epplein M, Reed SD, Voigt LF, Newton KM, Holt VL, Weiss NS. Risk of complex and atypical endometrial hyperplasia in relation to anthropometric measures and reproductive history. Am J Epidemiol. 2008;168 (6):563-570; discussion 571-6.doi: 10.1093/aje/kwn168.
Haoula Z, Salman M, Atiomo W. Evaluating the association between endometrial cancer and polycystic ovary syndrome. Hum Reprod. 2012;27 (5):1327-1331. doi:10.1093/humrep/des042.
Chamlian DL, Taylor HB. Endometrial hyperplasia in young women. Obstet Gynecol. 1970;36 (5):659-666. PMID: 5473992.
Polycstic ovary sindrome. World Heath Oraganization. Disponible en: https://www.who.int/news-room/fact-sheets/ detail/polycystic-ovarysyndrome#:~:text=Key%20 facts,affected%20women%20remain%20undiagnosed%20worldwid. Revisado en marzo 20, 2024.
Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89 (6):2745-2749. doi: 10.1210/jc.2003-032046.
Parazzini F, La Vecchia C, Bocciolone L, Franceschi S. The epidemiology of endometrial cancer. Gynecol Oncol. 1991;41 (1):1-16. doi: 10.1016/0090-8258(91)90246-2.
Fisher B, Costantino JP, Redmond CK, Fisher ER, Wickerham DL, Cronin WM. Endometrial cancer in tamoxifen-treated breast cancer patients: findings from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-14. J Natl Cancer Inst. 1994;86 (7):527-537. doi: 10.1093/jnci/86.7.527.
Runowicz CD, Costantino JP, Wickerham DL, Cecchini RS, Cronin WM, Ford LG, Vogel VG, Wolmark N. Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR). Am J Obstet Gynecol. 2011; 205 (6):535.e1-5. doi: 10.1016/j.ajog.2011.06.067.
Cummings SR, Eckert S, Krueger KA, Grady D, Powles TJ, Cauley JA, Norton L, Nickelsen T, Bjarnason NH, Morrow M, Lippman ME, Black D, Glusman JE, Costa A, Jordan VC. The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation. JAMA. 1999;281 (23):2189-2197. doi: 10.1001/jama.281.23.2189. Erratum in: JAMA 1999;282 (22):2124. PMID: 10376571.
Win AK, Young JP, Lindor NM, Tucker KM, Ahnen DJ, Young GP, Buchanan DD, Clendenning M, Giles GG, Winship I, Macrae FA, Goldblatt J, Southey MC, Arnold J, Thibodeau SN, Gunawardena SR, Bapat B, Baron JA, Casey G, Gallinger S, Le Marchand L, Newcomb PA, Haile RW, Hopper JL, Jenkins MA. Colorectal and other cancer risks for carriers and noncarriers from families with a DNA mismatch repair gene mutation: a prospective cohort study. J Clin Oncol. 2012;30(9):958-964. doi: 10.1200/JCO.2011.39.5590.
Stoffel E, Mukherjee B, Raymond VM, Tayob N, Kastrinos F, Sparr J, Wang F, Bandipalliam P, Syngal S, Gruber SB. Calculation of risk of colorectal and endometrial cancer among patients with Lynch syndrome. Gastroenterology. 2009;137 (5):1621-1627. doi: 10.1053/j.gastro.2009.07.039.
Gallagher EJ, LeRoith D. Diabetes, cancer, and metformin: connections of metabolism and cell proliferation. Ann N Y Acad Sci. 2011; 1243:54-68. doi: 10.1111/j.1749-6632.2011.06285.x.
Saed L, Varse F, Baradaran HR, Moradi Y, Khateri S, Friberg E, Khazaei Z, Gharahjeh S, Tehrani S, Sioofy-Khojine AB, Najmi Z. The effect of diabetes on the risk of endometrial Cancer: an updated a systematic review and meta-analysis. BMC Cancer. 2019;19 (1):527. doi: 10.1186/ s12885-019-5748-4.
Núñez-Troconis J. Uso de la metformina en cáncer ginecológico. Gac Méd Caracas 2021;129(1):88-106. doi: 10.47307/GMC.2021.129.1.12.
Levine RL, Cargile CB, Blazes MS, van Rees B, Kurman RJ, Ellenson LH. PTEN mutations and microsatellite instability in complex atypical hyperplasia, a precursor lesion to uterine endometrioid carcinoma. Cancer Res. 1998;58 (15):3254-3258.PMID: 9699651.
Maxwell GL, Risinger JI, Gumbs C, Shaw H, Bentley RC, Barrett JC, Berchuck A, Futreal PA. Mutation of the PTEN tumor suppressor gene in endometrial hyperplasias. Cancer Res. 1998; 58 (12):2500-2503. PMID: 9635567.
Dobrzycka B, Terlikowski SJ, Mazurek A, Kowalczuk O, Niklińska W, Chyczewski L, Kulikowski M. Mutations of the KRAS oncogene in endometrial hyperplasia and carcinoma. Folia Histochem Cytobiol. 2009;47 (1):65-68. doi: 10.2478/v10042-009-0014-2.
Saegusa M, Hashimura M, Yoshida T, Okayasu I. beta Catenin mutations and aberrant nuclear expression during endometrial tumorigenesis. Br J Cancer. 200;84 (2):209-217. doi: 10.1054/bjoc.2000.1581.
Hayes MP, Wang H, Espinal-Witter R, Douglas W, Solomon GJ, Baker SJ, Ellenson LH. PIK3CA and PTEN mutations in uterine endometrioid carcinoma and complex atypical hyperplasia. Clin Cancer Res. 2006;12 (20 Pt 1):5932-5. doi: 10.1158/1078-0432.CCR-06-1375.
Hardisson D, Moreno-Bueno G, Sánchez L, Sarrió D, Suárez A, Calero F, Palacios J. Tissue microarray immunohistochemical expression analysis of mismatch repair (hMLH1 and hMSH2 genes) in endometrial carcinoma and atypical endometrial hyperplasia: relationship with microsatellite instability. Mod Pathol. 2003;16(11):1148-1158. doi: 10.1097/01.MP.0000095646.70007.6A.
Fabjani G, Kucera E, Schuster E, Minai-Pour M, Czerwenka K, Sliutz G, Leodolter S, Reiner A, Zeillinger R. Genetic alterations in endometrial hyperplasia and cancer. Cancer Lett. 2002;175(2):205-211. doi: 10.1016/s0304-3835(01)00714-5.
O’Hara AJ, Bell DW. The genomics and genetics of endometrial cancer. Adv Genomics Genet. 2012;2012(2):33-47. doi: 10.2147/AGG.S28953.
Dieudonné AS, Lambrechts D, Smeets D, Belmans A, Wildiers H, Paridaens R, Hyonil C, Timmerman D, Christiaens MR, Vergote I, Neven P. The rs1800716 variant in CYP2D6 is associated with an increased double endometrial thickness in postmenopausal women on tamoxifen. Ann Oncol. 2014;25 (1):90-95. doi: 10.1093/annonc/mdt399.
Aban M, Arslan M, Tok E, Tekes S, Budak T, Altintas A. CYP17 genetic polymorphism in patients with endometrial hyperplasia and cancer. Int J Gynecol Cancer. 2006; 16 Suppl 1:448-4 51. doi: 10.1111/j.1525-1438.2006.00417.x.
Ivanova TI, Krikunova LI, Ryabchenko NI, Mkrtchyan LS, Khorokhorina VA, Salnikova LE. Association of the apolipoprotein E 2 allele with concurrent occurrence of endometrial hyperplasia and endometrial carcinoma. Oxid Med Cell Longev. 2015; 2015:593658. doi: 10.1155/2015/593658.
Gerhard D. The Largest Whole-genome Sequencing Study in Cancer. Disponible en: https://www.the-scientist.com/the-largest-whole-genome-sequencing-study-in- cancer71782?utm_campaign=TS_News%20Alerts_2024&utm_medium=email&_ hsenc=p2ANqtz-9yVsb3ARwUmZuhMBcvBnRF_5AkrVYrogPpIICvBAkmvXpHVkRksOUI88_pET6PfQcWoZ0Fc5eITnA1jIs- C7OevhCZCA&_hsmi=3030930. Revisado en mayo 4, 2024.
Baskin GB, Smith SM, Marx PA. Endometrial hyperplasia, polyps, and adenomyosis associated with unopposed estrogen in rhesus monkeys (Macaca mulatta). Vet Pathol. 2002;39(5):572-575. doi: 10.1354/ vp.39-5-572. PMID: 12243467.
Grady D, Gebretsadik T, Kerlikowske K, Ernster V, Petitti D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet Gynecol. 1995;85 (2):304-313. doi: 10.1016/0029-7844(94)00383-O.
Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. The Writing Group for the PEPI Trial. JAMA. 1996;275 (5):370-375. doi: 10.1001/jama.1996.03530290040035.
Zhdanov AV, Sukhikh GT, Davydova MP, Slukina TV, Chernukha GE, Samoilova TE, Smetnik VP. Correlations in the cytokine system in endometrial hyperplasia. Bull Exp Biol Med. 2003;136 (3):270-272. doi: 10.1023/b: bebm.0000008980.25653.1b.
Sukhikh GT, Zhdanov AV, Davydova MP, Slukina TV, Chernukha GE, Samoilova TE, Smetnik VP. Disorders in cytokine gene expression in endometrial hyperplasia and effect of hormone therapy. Bull Exp Biol Med. 2005;139 (2):235-237. doi: 10.1007/s10517-005-0257-7.
Bruchim I, Sarfstein R, Werner H. The IGF Hormonal Network in Endometrial Cancer: Functions, Regulation, and Targeting Approaches. Front Endocrinol (Lausanne). 2014; 5: 76. doi: 10.3389/fendo.2014.00076.
McCampbell AS, Broaddus RR, Loose DS, Davies PJ. Overexpression of the insulin-like growth factor I receptor and activation of the AKT pathway in hyperplastic endometrium. Clin Cancer Res. 2006;12 (21):6373-6378. doi: 10.1158/1078-0432. CCR-06-0912.
Vaskivuo TE, Stenbäck F, Tapanainen JS. Apoptosis and apoptosis-related factors Bcl-2, Bax, tumor necrosis factor-alpha, and NF-kappaB in human endometrial hyperplasia and carcinoma. Cancer. 2002;95 (7):1463-1471. doi: 10.1002/cncr.10876.
Schumer ST, Cannistra SA. Granulosa Cell Tumor of the Ovary. J Clinical Oncol. 2003:21(6): 1180-1189 https://doi. org/10.1200/JCO.2003.10.019.
Vilos G, Lefebvre G, Graves G. SOGC Clinical Practice Guidelines Committee Members. Guidelines for the management of abnormal uterine bleeding. J Obstet Gynaecol Can 2001; 106:704-709. doi: 10.1016/S0849-5831(16)31463-X. Disponible en: https://www.researchgate. net/publication/284144950_Guidelines_for_the_management_of_abnormal_uterine_bleeding. Revisado en mayo 16, 2024
Speroff´s Clinical Gynecologic Endocrinology and Infertility. Abnormal uterine bleeding. Chapter 15. Editors: Taylor HS, Pal L, Seli E. Editorilal Wolters Kluwer. 9th Edition. 2020, p 1214-1302.
Munro MG, Critchley HO, Broder MS, Fraser IS; FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113 (1):3-13. doi: 10.1016/j.ijgo.2010.11.011.
National Collaborating Centre for Women’s and Children’s Health (UK). Heavy Menstrual Bleeding. London: RCOG Press; 2007 Jan. PMID: 21938862.
American College of Obstetricians and Gynecologists (ACOG). Committee Opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Obstet Gynecol. 2013;121 (4):891-896, reaffirmed 2019.
Ash SJ, Farrell SA, Flowerdew G. Endometrial biopsy in DUB. J Reprod Med. 1996; 41 (12):892-896. PMID: 8979202.
Guido RS, Kanbour-Shakir A, Rulin MC, Christopherson WA. Pipelle endometrial sampling. Sensitivity in the detection of endometrial cancer. J Reprod Med. 1995; 40 (8):553-555. PMID: 7473450.
Llavarasi CR, Jyothi GS, Alva NK. Study of the efficacy of Pipelle Biopsy Technique to diagnose endometrial diseases in abnormal uterine bleeding. J Midlife Health. 2019;10 (2):75-80. doi: 10.4103/jmh.JMH_109_18.
Dijkhuizen FP, Brölmann HA, Potters AE, Bongers MY, Heinz AP. The accuracy of transvaginal ultrasonography in the diagnosis of endometrial abnormalities. Obstet Gynecol. 1996; 87 (3):345-349. doi: 10.1016/0029-7844(95)00450-5.
Nagele F, O’Connor H, Davies A, Badawy A, Mohamed H, Magos A. 2500 Outpatient diagnostic hysteroscopies. Obstet Gynecol. 1996; 88 (1):87-92. doi: 10.1016/0029-7844(96)00108-1.
Gupta JK, Chien PF, Voit D, Clark TJ, Khan KS. Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta-analysis. Acta Obstet Gynecol Scand. 2002; 81 (9):799-816. doi: 10.1034/j.1600-0412.2001.810902.x.
Gull B, Karlsson B, Milsom I, Granberg S. Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol. 2003; 188 (2):401-408. doi: 10.1067/mob.2003.154.
Paraskevaidis E, Kalantaridou SN, Papadimitriou D, Pappa L, Malamou-Mitsi V, Zikopoulos K, Kazantzis E, Lolis ED, Agnantis NJ. Transvaginal uterine ultrasonography compared with endometrial biopsy for the detection of endometrial disease in perimenopausal women with uterine bleeding. Anticancer Res. 2002; 22 (3):1829-1832. PMID: 12168877.
Natarajan P, Vinturache A, Hutson R, Nugent D, Broadhead T. The value of MRI in management of endometrial hyperplasia with atypia. World J Surg Oncol. 2020; 18 (1):34. doi: 10.1186/s12957-020-1811-5.
Montgomery BE, Daum GS, Dunton CJ. Endometrial hyperplasia: a review. Obstet Gynecol Surv. 2004;59(5):368-378. doi: 10.1097/00006254-200405000-00025.
Höhn AK, Brambs CE, Hiller GGR, May D, Schmoeckel E, Horn LC. 2020 WHO Classification of Female Genital Tumors. Geburtshilfe Frauenheilkd. 2021;81(10):1145-1153. doi: 10.1055/a-1545-4279.
Ring KL, Mills AM, Modesitt SC. Endometrial Hyperplasia. Obstet Gynecol. 2022;140(6):1061-1075. doi: 10.1097/AO G.0000000000004989.
Ricci E, Moroni S, Parazzini F, Surace M, Benzi G, Salerio B, Polverino G, La Vecchia C. Risk factors for endometrial hyperplasia: results from a case-control study. Int J Gynecol Cancer. 2002;12(3):257-260. doi: 10.1046/j.1525-1438.2002.01105x.
Armstrong AJ, Hurd WW, Elguero S, Barker NM, Zanotti KM. Diagnosis and management of endometrial hyperplasia. J Minim Invasive Gynecol. 2012;19(5):562- 571. doi: 10.1016/j.jmig.2012.05.009.
Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K, Voigt LF, Weiss NS. Incidence of endometrial hyperplasia. Am J Obstet Gynecol. 2009;200(6):678. doi: 10.1016/j.ajog.2009.02.032.
Natarajan P, Vinturache A, Hutson R, Nugent D, Broadhead T. The value of MRI in management of endometrial hyperplasia with atypia. World J Surg Oncol. 2020 10;18(1):34. doi: 10.1186/s12957-020-1811-5.
Whitaker L, Critchley HO. Abnormal Uterine Bleeding. Best Pract Res Clin Obstet Gynaecol. 2016;34:54-65. doi: 10.1016/j.bpobgyn.2015.11.012.
Corpus uterei. Cancer Today. Globocan 2022 International Agency for Cancer Research. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefind-mkaj/https://gco.iarc.who.int/media/globocan/factsheets/cancers/24-corpus-uteri-fact-sheet.pdf. Revisado en junio 11, 2024.
Endometrial cancer statistics. World Cancer Research Fund International. Disponible en: https://www.wcrf.org/ cancer-trends/endometrial-cancer- statistics/#:~:text=There%20were%20420%2C368%20new%20cases%20of%20endometrial%20cancer%20in%202022. Revisado en junio 11, 2024.
Estadísticas importantes sobre el cáncer de endometrio. American Cancer Society. Disponible en: https://www.cancer.org/es/cancer/tipos/cancer-deendometrio/acerca/estadisticas-clave.html. Revisado en septiembre 09, 2024.
Siegel RL, Miller KD, Wagle NS, Jemal Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48. doi: 10.3322/ caac.21763. PMID: 36633525.
National Cancer Institute Surveillance, Epidemiology, and End Results Program. Cancer stat facts: uterine cancer. Disponible en: https://seer.cancer.gov/statfacts/html/corp.html. Revisado en noviembre 6, 2023.
Coulam CB, Annegers JF, Kranz JS. Chronic anovulation syndrome and associated neoplasia. Obstet Gynecol. 1983;61(4):403-407. PMID: 6828267.
Göl K, Saraçoğlu F, Ekici A, Sahin I. Endometrial patterns and endocrinologic characteristics of asymptomatic menopausal women. Gynecol Endocrinol. 2001;15(1):63-67. PMID: 11293927.
Tsujimoto Y, Finger LR, Yunis J, Nowell PC, Croce CM. Cloning of the chromosome breakpoint of neoplastic B cells with the t(14;18) chromosome translocation. Science. 1984 30; 226 (4678):1097-1099.doi: 10.1126/science.6093263.
Cleary ML, Sklar J. Nucleotide sequence of a t (14;18) chromosomal breakpoint in follicular lymphoma and demonstration of a breakpoint-cluster region near a transcriptionally active locus on chromosome 18. Proc Natl Acad Sci U S A. 1985;82 (21):7439-7443. doi: 10.1073/pnas.82.21.7439.
Nuñez G, London L, Hockenbery D, Alexander M, McKearn JP, Korsmeyer SJ. Deregulated Bcl-2 gene expression selectively prolongs survival of growth factor-deprived hemopoietic cell lines. J Immunol. 1990;144 (9):3602-3610. PMID: 2184193.
Gompel A, Sabourin JC, Martin A, Yaneva H, Audouin J, Decroix Y, Poitout P. Bcl-2 expression in normal endometrium during the menstrual cycle. Am J Pathol. 1994;144 (6):1195-1202. PMID: 8203460; PMCID: PMC1887458.
Otsuki Y, Misaki O, Sugimoto O, Ito Y, Tsujimoto Y, Akao Y. Cyclic bcl-2 gene expression in human uterine endometrium during menstrual cycle. Lancet. 1994;344 (8914):28-29. doi: 10.1016/s0140-6736(94)91051-0.
Hopwood D, Levison DA. Atrophy and apoptosis in the cyclical human endometrium. J Pathol. 1976; 119 (3):159-66. doi: 10.1002/path.1711190305. PMID: 956955.
Niemann TH, Trgovac TL, McGaughy VR, Vaccarello L. bcl-2 expression in endometrial hyperplasia and carcinoma. Gynecol Oncol. 199; 63 (3):318-322. doi: 10.1006/gyno.1996.0329. PMID: 8946865.
Wang S, Pudney J, Song J, Mor G, Schwartz PE, Zheng W. Mechanisms involved in the evolution of progestin resistance in human endometrial hyperplasia--precursor of endometrial cancer. Gynecol Oncol. 2003;88 (2):108-117. doi: 10.1016/s0090-8258(02)00008-2.
Maruo T, Laoag-Fernandez JB, Pakarinen P, Murakoshi H, Spitz IM, Johansson E. Effects of the levonorgestrel-releasing intrauterine system on proliferation and apoptosis in the endometrium. Hum Reprod. 2001; 16 (10):2103-2108. doi:10.1093/humrep/16.10.2103.
Chandra V, Kim JJ, Benbrook DM, Dwivedi A, Rai R. Therapeutic options for management of endometrial hyperplasia. J Gynecol Oncol. 2016;27 (1): e8. doi: 10.3802/jgo.2016.27.e8.
Ronnett BM, Kurman RJ. Precursor lesions of endometrial carcinoma. In: Kurman RJ, ed. Blaustein’s Pathology of the Female Genital Tract, 5th ed. New York: Springer-Verlag, 2002: 467–500.
Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients. Cancer. 1985;56(2):403-412. doi: 10.1002/1097-0142(19850715)56: 2<403::aid-cncr2820560233>3.0.co;2-x.
Terakawa N, Kigawa J, Taketani Y, Yoshikawa H, Yajima A, Noda K, Okada H, Kato J, Yakushiji M, Tanizawa O, Fujimoto S, Nozawa S, Takahashi T, Hasumi K, Furuhashi N, Aono T, Sakamoto A, Furusato M. The behavior of endometrial hyperplasia: a prospective study. Endometrial Hyperplasia Study Group. J Obstet Gynaecol Res. 1997;23(3):223-230. doi: 10.1111/j.1447-0756.1997.tb00836.x.
Bernstein S. A visual guide to uterine papillary serous carcinoma. Disponible en: https://www.webmd.com/cancer/cervical- cancer/ss/slideshow-uterine-papillar y serous-carcinoma. Revisado en: Marzo 14, 2024.
Bernstein L. The risk of breast, endometrial and ovarian cancer in users of hormonal preparations. Basic Clin Pharmacol Toxicol. 2006;98(3):288-296. doi: 10.1111/j.1742-7843.2006.pto_277.x.
WHO Classification of Tumours of Female Reproductive Organs. WHO Classification of Tumours, 4th Edition. 2024. Volume 6. Edited by Kurman RJ, Carcangiu ML, Herrington CS, Young RH.
Bacon JL. Abnormal Uterine Bleeding: Current Classification and Clinical Management. Obstet Gynecol Clin North Am. 2017;44(2):179-193. doi: 10.1016/j. ogc.2017.02.012.
Opolskiene G, Sladkevicius P, Valentin L. Prediction of endometrial malignancy in women with postmenopausal bleeding and sonographic endometrial thickness ≥ 4.5 mm. Ultrasound Obstet Gynecol. 2011;37(2):232-240. doi: 10.1002/uog.8871.
MacDonald PC, Edman CD, Hemsell DL, Porter JC, Siiteri PK. Effect of obesity on conversion of plasma androstenedione to estrone in postmenopausal women with and without endometrial cancer. Am J Obstet Gynecol. 1978;130 (4):448-455. doi: 10.1016/0002-9378(78)90287-9.
Kaye SA, Folsom AR, Soler JT, Prineas RJ, Potter JD. Associations of body mass and fat distribution with sex hormone concentrations in postmenopausal women. Int J Epidemiol. 1991;20 (1):151-156. doi: 10.1093/ije/20.1.151.
Epplein M, Reed SD, Voigt LF, Newton KM, Holt VL, Weiss NS. Risk of complex and atypical endometrial hyperplasia in relation to anthropometric measures and reproductive history. Am J Epidemiol. 2008;168 (6):563-570; discussion 571-6.doi: 10.1093/aje/kwn168.
Haoula Z, Salman M, Atiomo W. Evaluating the association between endometrial cancer and polycystic ovary syndrome. Hum Reprod. 2012;27 (5):1327-1331. doi:10.1093/humrep/des042.
Chamlian DL, Taylor HB. Endometrial hyperplasia in young women. Obstet Gynecol. 1970;36 (5):659-666. PMID: 5473992.
Polycstic ovary sindrome. World Heath Oraganization. Disponible en: https://www.who.int/news-room/fact-sheets/ detail/polycystic-ovarysyndrome#:~:text=Key%20 facts,affected%20women%20remain%20undiagnosed%20worldwid. Revisado en marzo 20, 2024.
Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89 (6):2745-2749. doi: 10.1210/jc.2003-032046.
Parazzini F, La Vecchia C, Bocciolone L, Franceschi S. The epidemiology of endometrial cancer. Gynecol Oncol. 1991;41 (1):1-16. doi: 10.1016/0090-8258(91)90246-2.
Fisher B, Costantino JP, Redmond CK, Fisher ER, Wickerham DL, Cronin WM. Endometrial cancer in tamoxifen-treated breast cancer patients: findings from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-14. J Natl Cancer Inst. 1994;86 (7):527-537. doi: 10.1093/jnci/86.7.527.
Runowicz CD, Costantino JP, Wickerham DL, Cecchini RS, Cronin WM, Ford LG, Vogel VG, Wolmark N. Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR). Am J Obstet Gynecol. 2011; 205 (6):535.e1-5. doi: 10.1016/j.ajog.2011.06.067.
Cummings SR, Eckert S, Krueger KA, Grady D, Powles TJ, Cauley JA, Norton L, Nickelsen T, Bjarnason NH, Morrow M, Lippman ME, Black D, Glusman JE, Costa A, Jordan VC. The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation. JAMA. 1999;281 (23):2189-2197. doi: 10.1001/jama.281.23.2189. Erratum in: JAMA 1999;282 (22):2124. PMID: 10376571.
Win AK, Young JP, Lindor NM, Tucker KM, Ahnen DJ, Young GP, Buchanan DD, Clendenning M, Giles GG, Winship I, Macrae FA, Goldblatt J, Southey MC, Arnold J, Thibodeau SN, Gunawardena SR, Bapat B, Baron JA, Casey G, Gallinger S, Le Marchand L, Newcomb PA, Haile RW, Hopper JL, Jenkins MA. Colorectal and other cancer risks for carriers and noncarriers from families with a DNA mismatch repair gene mutation: a prospective cohort study. J Clin Oncol. 2012;30(9):958-964. doi: 10.1200/JCO.2011.39.5590.
Stoffel E, Mukherjee B, Raymond VM, Tayob N, Kastrinos F, Sparr J, Wang F, Bandipalliam P, Syngal S, Gruber SB. Calculation of risk of colorectal and endometrial cancer among patients with Lynch syndrome. Gastroenterology. 2009;137 (5):1621-1627. doi: 10.1053/j.gastro.2009.07.039.
Gallagher EJ, LeRoith D. Diabetes, cancer, and metformin: connections of metabolism and cell proliferation. Ann N Y Acad Sci. 2011; 1243:54-68. doi: 10.1111/j.1749-6632.2011.06285.x.
Saed L, Varse F, Baradaran HR, Moradi Y, Khateri S, Friberg E, Khazaei Z, Gharahjeh S, Tehrani S, Sioofy-Khojine AB, Najmi Z. The effect of diabetes on the risk of endometrial Cancer: an updated a systematic review and meta-analysis. BMC Cancer. 2019;19 (1):527. doi: 10.1186/ s12885-019-5748-4.
Núñez-Troconis J. Uso de la metformina en cáncer ginecológico. Gac Méd Caracas 2021;129(1):88-106. doi: 10.47307/GMC.2021.129.1.12.
Levine RL, Cargile CB, Blazes MS, van Rees B, Kurman RJ, Ellenson LH. PTEN mutations and microsatellite instability in complex atypical hyperplasia, a precursor lesion to uterine endometrioid carcinoma. Cancer Res. 1998;58 (15):3254-3258.PMID: 9699651.
Maxwell GL, Risinger JI, Gumbs C, Shaw H, Bentley RC, Barrett JC, Berchuck A, Futreal PA. Mutation of the PTEN tumor suppressor gene in endometrial hyperplasias. Cancer Res. 1998; 58 (12):2500-2503. PMID: 9635567.
Dobrzycka B, Terlikowski SJ, Mazurek A, Kowalczuk O, Niklińska W, Chyczewski L, Kulikowski M. Mutations of the KRAS oncogene in endometrial hyperplasia and carcinoma. Folia Histochem Cytobiol. 2009;47 (1):65-68. doi: 10.2478/v10042-009-0014-2.
Saegusa M, Hashimura M, Yoshida T, Okayasu I. beta Catenin mutations and aberrant nuclear expression during endometrial tumorigenesis. Br J Cancer. 200;84 (2):209-217. doi: 10.1054/bjoc.2000.1581.
Hayes MP, Wang H, Espinal-Witter R, Douglas W, Solomon GJ, Baker SJ, Ellenson LH. PIK3CA and PTEN mutations in uterine endometrioid carcinoma and complex atypical hyperplasia. Clin Cancer Res. 2006;12 (20 Pt 1):5932-5. doi: 10.1158/1078-0432.CCR-06-1375.
Hardisson D, Moreno-Bueno G, Sánchez L, Sarrió D, Suárez A, Calero F, Palacios J. Tissue microarray immunohistochemical expression analysis of mismatch repair (hMLH1 and hMSH2 genes) in endometrial carcinoma and atypical endometrial hyperplasia: relationship with microsatellite instability. Mod Pathol. 2003;16(11):1148-1158. doi: 10.1097/01.MP.0000095646.70007.6A.
Fabjani G, Kucera E, Schuster E, Minai-Pour M, Czerwenka K, Sliutz G, Leodolter S, Reiner A, Zeillinger R. Genetic alterations in endometrial hyperplasia and cancer. Cancer Lett. 2002;175(2):205-211. doi: 10.1016/s0304-3835(01)00714-5.
O’Hara AJ, Bell DW. The genomics and genetics of endometrial cancer. Adv Genomics Genet. 2012;2012(2):33-47. doi: 10.2147/AGG.S28953.
Dieudonné AS, Lambrechts D, Smeets D, Belmans A, Wildiers H, Paridaens R, Hyonil C, Timmerman D, Christiaens MR, Vergote I, Neven P. The rs1800716 variant in CYP2D6 is associated with an increased double endometrial thickness in postmenopausal women on tamoxifen. Ann Oncol. 2014;25 (1):90-95. doi: 10.1093/annonc/mdt399.
Aban M, Arslan M, Tok E, Tekes S, Budak T, Altintas A. CYP17 genetic polymorphism in patients with endometrial hyperplasia and cancer. Int J Gynecol Cancer. 2006; 16 Suppl 1:448-4 51. doi: 10.1111/j.1525-1438.2006.00417.x.
Ivanova TI, Krikunova LI, Ryabchenko NI, Mkrtchyan LS, Khorokhorina VA, Salnikova LE. Association of the apolipoprotein E 2 allele with concurrent occurrence of endometrial hyperplasia and endometrial carcinoma. Oxid Med Cell Longev. 2015; 2015:593658. doi: 10.1155/2015/593658.
Gerhard D. The Largest Whole-genome Sequencing Study in Cancer. Disponible en: https://www.the-scientist.com/the-largest-whole-genome-sequencing-study-in- cancer71782?utm_campaign=TS_News%20Alerts_2024&utm_medium=email&_ hsenc=p2ANqtz-9yVsb3ARwUmZuhMBcvBnRF_5AkrVYrogPpIICvBAkmvXpHVkRksOUI88_pET6PfQcWoZ0Fc5eITnA1jIs- C7OevhCZCA&_hsmi=3030930. Revisado en mayo 4, 2024.
Baskin GB, Smith SM, Marx PA. Endometrial hyperplasia, polyps, and adenomyosis associated with unopposed estrogen in rhesus monkeys (Macaca mulatta). Vet Pathol. 2002;39(5):572-575. doi: 10.1354/ vp.39-5-572. PMID: 12243467.
Grady D, Gebretsadik T, Kerlikowske K, Ernster V, Petitti D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet Gynecol. 1995;85 (2):304-313. doi: 10.1016/0029-7844(94)00383-O.
Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. The Writing Group for the PEPI Trial. JAMA. 1996;275 (5):370-375. doi: 10.1001/jama.1996.03530290040035.
Zhdanov AV, Sukhikh GT, Davydova MP, Slukina TV, Chernukha GE, Samoilova TE, Smetnik VP. Correlations in the cytokine system in endometrial hyperplasia. Bull Exp Biol Med. 2003;136 (3):270-272. doi: 10.1023/b: bebm.0000008980.25653.1b.
Sukhikh GT, Zhdanov AV, Davydova MP, Slukina TV, Chernukha GE, Samoilova TE, Smetnik VP. Disorders in cytokine gene expression in endometrial hyperplasia and effect of hormone therapy. Bull Exp Biol Med. 2005;139 (2):235-237. doi: 10.1007/s10517-005-0257-7.
Bruchim I, Sarfstein R, Werner H. The IGF Hormonal Network in Endometrial Cancer: Functions, Regulation, and Targeting Approaches. Front Endocrinol (Lausanne). 2014; 5: 76. doi: 10.3389/fendo.2014.00076.
McCampbell AS, Broaddus RR, Loose DS, Davies PJ. Overexpression of the insulin-like growth factor I receptor and activation of the AKT pathway in hyperplastic endometrium. Clin Cancer Res. 2006;12 (21):6373-6378. doi: 10.1158/1078-0432. CCR-06-0912.
Vaskivuo TE, Stenbäck F, Tapanainen JS. Apoptosis and apoptosis-related factors Bcl-2, Bax, tumor necrosis factor-alpha, and NF-kappaB in human endometrial hyperplasia and carcinoma. Cancer. 2002;95 (7):1463-1471. doi: 10.1002/cncr.10876.
Schumer ST, Cannistra SA. Granulosa Cell Tumor of the Ovary. J Clinical Oncol. 2003:21(6): 1180-1189 https://doi. org/10.1200/JCO.2003.10.019.
Vilos G, Lefebvre G, Graves G. SOGC Clinical Practice Guidelines Committee Members. Guidelines for the management of abnormal uterine bleeding. J Obstet Gynaecol Can 2001; 106:704-709. doi: 10.1016/S0849-5831(16)31463-X. Disponible en: https://www.researchgate. net/publication/284144950_Guidelines_for_the_management_of_abnormal_uterine_bleeding. Revisado en mayo 16, 2024
Speroff´s Clinical Gynecologic Endocrinology and Infertility. Abnormal uterine bleeding. Chapter 15. Editors: Taylor HS, Pal L, Seli E. Editorilal Wolters Kluwer. 9th Edition. 2020, p 1214-1302.
Munro MG, Critchley HO, Broder MS, Fraser IS; FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113 (1):3-13. doi: 10.1016/j.ijgo.2010.11.011.
National Collaborating Centre for Women’s and Children’s Health (UK). Heavy Menstrual Bleeding. London: RCOG Press; 2007 Jan. PMID: 21938862.
American College of Obstetricians and Gynecologists (ACOG). Committee Opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Obstet Gynecol. 2013;121 (4):891-896, reaffirmed 2019.
Ash SJ, Farrell SA, Flowerdew G. Endometrial biopsy in DUB. J Reprod Med. 1996; 41 (12):892-896. PMID: 8979202.
Guido RS, Kanbour-Shakir A, Rulin MC, Christopherson WA. Pipelle endometrial sampling. Sensitivity in the detection of endometrial cancer. J Reprod Med. 1995; 40 (8):553-555. PMID: 7473450.
Llavarasi CR, Jyothi GS, Alva NK. Study of the efficacy of Pipelle Biopsy Technique to diagnose endometrial diseases in abnormal uterine bleeding. J Midlife Health. 2019;10 (2):75-80. doi: 10.4103/jmh.JMH_109_18.
Dijkhuizen FP, Brölmann HA, Potters AE, Bongers MY, Heinz AP. The accuracy of transvaginal ultrasonography in the diagnosis of endometrial abnormalities. Obstet Gynecol. 1996; 87 (3):345-349. doi: 10.1016/0029-7844(95)00450-5.
Nagele F, O’Connor H, Davies A, Badawy A, Mohamed H, Magos A. 2500 Outpatient diagnostic hysteroscopies. Obstet Gynecol. 1996; 88 (1):87-92. doi: 10.1016/0029-7844(96)00108-1.
Gupta JK, Chien PF, Voit D, Clark TJ, Khan KS. Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta-analysis. Acta Obstet Gynecol Scand. 2002; 81 (9):799-816. doi: 10.1034/j.1600-0412.2001.810902.x.
Gull B, Karlsson B, Milsom I, Granberg S. Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol. 2003; 188 (2):401-408. doi: 10.1067/mob.2003.154.
Paraskevaidis E, Kalantaridou SN, Papadimitriou D, Pappa L, Malamou-Mitsi V, Zikopoulos K, Kazantzis E, Lolis ED, Agnantis NJ. Transvaginal uterine ultrasonography compared with endometrial biopsy for the detection of endometrial disease in perimenopausal women with uterine bleeding. Anticancer Res. 2002; 22 (3):1829-1832. PMID: 12168877.
Natarajan P, Vinturache A, Hutson R, Nugent D, Broadhead T. The value of MRI in management of endometrial hyperplasia with atypia. World J Surg Oncol. 2020; 18 (1):34. doi: 10.1186/s12957-020-1811-5.
Publicado
2025-03-06
Cómo citar
Núñez-Troconis, J. (2025). Hiperplasia endometrial: una revisión narrativa sobre su patogénesis, factores de riesgo y diagnóstico.: Endometrial hyperplasia: a narrative review on its pathogenesis, risk factors and diagnosis. Investigación Clínica, 66(1), 101-115. https://doi.org/10.54817/IC.v66n1a09
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