Endometrial hyperplasia and progression to cancer: which classification system stratifies the risk better? A systematic review and meta-analysis

Archives of Gynecology and Obstetrics
Antonio RaffoneFulvio Zullo

Abstract

Benign and precancerous endometrial hyperplasias (EH) are differentiated thorough two possible histomorphologic classifications: WHO (adopting the subjective evaluation of cytologic atypia) and EIN (adopting several histomorphologic parameters, evaluable subjectively, or objectively with a computerized analysis calculating a prognostic score, the D score). ACOG recommends the use of EIN system although no distinction was made between objective assessment (not widely available), and subjective assessment (more applicable in the common practice). Moreover, it is still unclear if subjective EIN system is actually preferable to WHO classification. We aimed to assess the reliability of WHO system, D score and subjective EIN system in stratifying the risk of progression to cancer in EH. MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID, Cochrane Library and Google Scholar were searched for relevant articles from the inception to August 2018. All studies assessing the rates of progression of EH to cancer were included. Twelve cohort studies and one case-control study, assessing 3629 EH, were included. Relative risk (RR) for cancer progression was calculated with 95% confidence interval (CI), and results were compared u...Continue Reading

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Dec 5, 2018·Acta Obstetricia Et Gynecologica Scandinavica·Antonio RaffoneFulvio Zullo
Feb 5, 2019·Acta Obstetricia Et Gynecologica Scandinavica·Antonio RaffoneFulvio Zullo

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Citations

Aug 14, 2019·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Antonio TravaglinoFulvio Zullo
Aug 25, 2019·Acta Obstetricia Et Gynecologica Scandinavica·Antonio RaffoneMaurizio Guida
Dec 8, 2019·Pathology Oncology Research : POR·Antonio TravaglinoFulvio Zullo
May 31, 2020·Pathology Oncology Research : POR·Antonio TravaglinoFulvio Zullo
Aug 25, 2019·Pathology Oncology Research : POR·Antonio RaffoneGian Franco Zannoni
Mar 18, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Antonio RaffoneFulvio Zullo
Sep 23, 2019·Archives of Gynecology and Obstetrics·Ruggero LionettiFrancesco Corcione
Mar 28, 2019·Archives of Gynecology and Obstetrics·Antonio RaffoneFulvio Zullo
Jun 17, 2019·Pathology Oncology Research : POR·Antonio RaffoneFulvio Zullo
Dec 20, 2019·Applied Immunohistochemistry & Molecular Morphology : AIMM·Antonio TravaglinoFulvio Zullo
Jun 27, 2019·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Antonio RaffoneFulvio Zullo
Apr 17, 2020·Archives of Gynecology and Obstetrics·Antonio TravaglinoFulvio Zullo
Jun 15, 2019·International Journal of Cancer. Journal International Du Cancer·Laura CostasUNKNOWN Screenwide Team
Jun 20, 2020·Journal of Computer Assisted Tomography·Ahmed Abdel Khalek Abdel RazekBasma N Gadelhak
Sep 19, 2019·Archives of Gynecology and Obstetrics·Antonio TravaglinoFulvio Zullo
Aug 23, 2019·American Journal of Clinical Pathology·Antonio TravaglinoFulvio Zullo
Sep 2, 2019·Gynecologic Oncology·Antonio RaffoneFulvio Zullo
Jun 24, 2020·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Marit L Bovbjerg, Melissa Cheyney
Jan 15, 2020·Gynecologic Oncology·Antonio RaffoneFulvio Zullo
Apr 9, 2021·Advances in Therapy·Maria-Eulalia Fernandez-MontoliNayanar-Adela Contreras-Perez
Jun 6, 2021·Gynecologic Oncology·Antonio RaffoneRenato Seracchioli

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