Problems with the current diagnostic approach to complex atypical endometrial hyperplasia

Abstract

The gas–liquid volumetric mass transfer coefficient was determined by the dynamic oxygen absorption technique using a polarographic dissolved oxygen probe and the gas–liquid interfacial area was measured using dual‐tip conductivity probes in a bubble column slurry reactor at ambient temperature and normal pressure. The solid particles used were ultrafine hollow glass microspheres with a mean diameter of 8.624 µm. The effects of various axial locations (height–diameter ratio = 1–12), superficial gas velocity (uG = 0.011–0.085 m/s) and solid concentration (εS = 0–30 wt.%) on the gas–liquid volumetric mass transfer coefficient kLaL and liquid‐side mass transfer coefficient kL were discussed in detail in the range of operating variables investigated. Empirical correlations by dimensional analysis were obtained and feed‐forward back propagation neural network models were employed to predict the gas–liquid volumetric mass transfer coefficient and liquid‐side mass transfer coefficient for an air–water–hollow glass microspheres system in a commercial‐scale bubble column slurry reactor. © 2012 Canadian Society for Chemical Engineering

Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan

“…Therefore, previous estimates of carcinoma risk based on consensus diagnoses of SH, CH, and AH (Kurman et al, 1985;Ferenczy and Gelfand, 1989;Montgomery et al, 2004;Horn et al, 2007) may require revision. Our findings reaffirm the need to improve the sensitivity and specificity of AH diagnoses (Soslow, 2006) and efficiently identify the rare nonatypical EH lesions that are likely to progress. Modern outpatient biopsy techniques achieve over 90% sensitivity for detecting carcinoma (Dijkhuizen et al, 2000), but better endometrial assessment (Zaino, 2000), histopathologic classifications (Mutter, 2002), and candidate molecular markers (Mutter, 2000) deserve further study.…”

“…Distinguishing low-risk EH lesions that can be conservatively managed with progestogen-based treatment plus surveillance from higher-risk EH lesions that require immediate surgical treatment has clinical implications (Clark et al, 2006;McCluggage, 2006;Soslow, 2006). There is no consensus on the management of SH or CH (Clark et al, 2006), which make up most EH diagnoses, but these lesions are thought to pose only modest risk of progression to carcinoma (Marsden and Hacker, 2001;Montgomery et al, 2004).…”

Decreased expression of P2X7 in endometrial epithelial pre-cancerous and cancer cells

“…Recent reports suggested that complex-atypia cells are found in the background of overt cancers [13][14][15]. This possibility was ruled out in the present study as all cases diagnosed initially as complex hyperplasia with atypia were re-evaluated and the histology was confirmed.…”

Risk factor analysis of coexisting endometrial carcinoma in patients with endometrial hyperplasia: a retrospective observational study of Taiwanese Gynecologic Oncology Group

“…However, the simple hyperplasia without atypia is similar to the normal proliferative endometrium and the complex hyperplasia with nuclear atypia resembles the well differentiated endometrioid adenocarcinoma [9]. Therefore, many previous studies have exhibited that the coexisting rate of endometrial carcinoma in patients with AEH varies from 15% to 54% [7,10-13].…”