Prevalensi Hiperplasia Endometrium Berkorelasi dengan Myoma Uteri

Nadya Hasna Rasyida Da,(1*) Aditiyono Aditiyono,(2) Gita Nawangtantrini,(3)

(1) Jenderal Soedirman University
(2) Divisi Ginekologi Onkologi RSUD Margono Soekarjo, Kabupaten Banyumas, Jawa Tengah
(3) Divisi Patologi Anatomi RSUD Margono Soekarjo, Kabupaten Banyumas, Jawa Tengah
(*) Corresponding Author

Abstract


Tujuan: Penelitian ini dilakukan untuk mengetahui prevalensi mioma uteri dengan koeksistensi hiperplasia endometrium pada RSUD Margono Soekarjo Purwokerto dalam rentang 2017−2019.
Metode: Penelitian ini menggunakan desain observational cross-sectional yang dilakukan di Pusat Onkologi di RSUD Margono Soekarjo Purwokerto. Sumber data adalah hasil pemeriksaan mikroskopis pada laboratorium Patologi Anatomi dari pasien yang dilakukan histerektomi dengan teknik total sampling pada rentang waktu tahun 2017-2019. Data kemudian dicatat hasil pengolahan data univariat dan ditampilkan dalam bentuk tabel.
Hasil: Dari 389 partisipan yang diteliti, terdapat 306 (78.7%) pasien terdiagnosa dengan mioma uteri tanpa hiperplasia endometrium dan 83 (21.3%) pasien dengan diagnosa mioma uteri disertai dengan koeksistensi hiperplasia endometrium. Dari 83 sampel pasien dengan koeksistensi hiperplasia endometrium, didapatkan 49 (59.0%) sampel memiliki gambaran hiperplasia simpleks non atipik, 14 sampel (16.9%) memiliki gambaran hiperplasia kompleks non atipik, 6 (7.2%) sampel dengan gambaran hiperplasia simpleks atipik dan 14 (16.9%) dengan gambaran hiperplasia kompleks atipik.
Kesimpulan: Mioma uteri banyak terjadi pada usia perimenopause karena ketidak seimbangan hormone antara estrogen dan progesterone. Mioma uteri dapat terjadi dengan atau tanpa koeksistensi dengan patologi lainnya, seperti hiperplasia endometrium, adenomyosis ataupun polip. Hiperplasia endometrium sering terjadi sebagai patologi sekunder, dengan prevalensi terbanyak adalah hiperplasia endometrium simpleks non atipik.

The Prevalence of Uterine Fibroid with Endometrial Hyperplasia Coexistence

Abstract
Objective: This study was conducted to determine the prevalence of uterine fibroids with the coexistence of endometrial hyperplasia at RSUD Margono Soekarjo Purwokerto in the period of 2017−2019.
Methods: This study used an observational cross-sectional design, conducted at the Oncology Center of RSUD Margono Soekarjo Purwokerto. The data used are the results of microscopic examinations of patients who underwent hysterectomy in the Anatomical Pathology laboratory with total sampling technique in the period of 2017-2019.
Results: Of the 389 participants studied, there were 306 (78.7%) patients diagnosed with uterine fibroids without endometrial hyperplasia and 83 (21.3%) patients with uterine fibroids with the coexistence of endometrial hyperplasia. From the 83 samples of patients with coexistence of endometrial hyperplasia, 49 (59.0%) samples had simple hyperplasia without atypia, 14 (16.9%) had complex hyperplasia without atypia, 6 (7.2%) had simple atypical hyperplasia and 14 ( 16.9%) with complex atypical hyperplasia.
Conclusion: Uterine fibroids often occur at perimenopausal age due to hormonal imbalance of estrogen and progesterone. Uterine fibroids may occur with or without coexistence of other pathologies, such as endometrial hyperplasia, adenomyosis or polyps. Endometrial hyperplasia often occurs as a secondary pathology, with the highest prevalence being simplex  hyperplasia without atypia.

Key words: uterine fibroid, endometrial hyperplasia, perimopause


Keywords


myoma uteri;hiperplasia endometrium;perimenopause

Full Text:

PDF

References


Baird DD, Dunson DB. Why is parity protective for uterine fibroids? Epidemiology 2003;14:247–250

Cook, J.D., Walker, C.L. 2004. Treatment Strategies for Uterine Leiomyoma: The Role of Hormonal Modulation. Seminars in Reproductive Medicine, 22(2), 105–111.doi:10.1055/s-2004-828616

Dayal, S., Nagath, A. 2016. Clinicopathological Correlation Of Endometrial, Myometrial And Ovarian Pathologies With Secondary Changes In Leiomyoma. Journal of Pathology of Nepal, vol 6, 937-941.

Doherty, M.T., Sanni, O.B., Coleman, H.G., Cardwell, C.R., McCluggage, W.G., et al. 2020. Concurrent and Future Risk of Endometrial Cancer in Women with Endometrial Hyperplasia: A Systematic Review and Meta-analysis. PLoS ONE 15(4).

Ellenson L.H., Ronnett B.M., Kurman R.J. Precursor Lesions of Endometrial Carcinoma. Blaustein’s Pathology of the Female Genital Tract. Boston, MA: Springer, 2011;359–392.

Geethamala, K., Murthy, V.S., Vani, B.R., Rao, S. 2016. Uterine Leiomyomas: An ENIGMA. Journal of Mid-Life Health 7(1):22-27

Ingin, R., Mangshetty, S., Jeevangi, G. 2019. A Retrospective Study of Uterine Leiomyomas With Associated Changes in Endometrium And Ovary. MedPulse International Journal of Pathology: 11(2) 77-80.

Kamal, A.M., Bulmer, M.J., DeCruze, S.B., Stringfellow, H.F., Martin-Hirsch, P., et al. 2016. Androgen Receptors Are Acquired By Healthy Postmenopausal Endometrial Epithelium And Their Subsequent Loss In Endometrial Cancer Is Associated With Poor Survival. British Journal of Cancer; 114: 688-696.

Khan, A.T., Shehmar, M., Gupta, J.K. 2014. Uterine Fibroids: Current Perspective. International Journal of Women’s Health pp: 95-114

Kumbhalwar, M.J., Konda, A. 2020. Prevalence of Uterine Lesions Associated with Leiomyomas and Role of Endometrial Biopsy in Management. International Journal of Reproduction, Contraception, Obstetric and Gynecology; 9(7):2828-2835

Kurman R., Carcangiu M., Herrington C., Young R. World Health Organisation Classification of Tumors of Female Reproductive Organs, 4th edn. Lyon France: International Agency for Research on Cancer (IARC) Press, 2014.

Palomba, S., Sammartino, A., Di Carlo, C., Affinito, P., Zullo, F., Nappi, C. 2001. Effects of Raloxifene Treatment on Uterine Leiomyomas in Postmenopausal Women. Fertility and Sterility 76(1), 38-43.

Reed, Susan D, et al. 2009. Incidence of Endometrial Hyperplasia. American Journal of Obstetric Gynecology 200 (6); 1-13

Rivzi, G., Pandey, H., Pant, H., Chufal, S.S., Pant, P. 2013. Histopathological Correlation of Adenomyosis and Leiomyoma in Hysterectomy Specimens as The Cause of Abnormal Uterine Bleeding in Women in Different Age Groups in The Kumaon Region: A Retroprospective Study. Journal of Mid-Life Health 4(1) 27-30

Sanderson, P.P., Critchey, O.D., Williams, R.W., Arends, M.J., Saunders, P.T.K. 2016. New Concept for an Old Problem: the Diagnosis of Endometrial Hyperplasia. Human Reproduction Update (4): 1-23.

Sobzcuk, K., Sobzcuk, A. 2017. New Classification System of Endometrial Hyperplasia WHO 2014 and Its Clinical Implementation. Menopause Rev 2017; 16(3): 107-111

Trimble C.L., Method M., Leitao M., Lu K., Ioffe O., Hampton M., Higgins R., Zaino R., Mutter G.L. Management of endometrial precancers. Obstetric and Gynecology 2012;120: 1160–1175.

Wei, J., MSa, Z., Weiyuan, Feng, Limin, et al. 2017. Comparison Of Fertility- Sparing Treatments In Patients With Early Endometrial Cancer And Atypical Complex Hyperplasia. Medicine Systematic Reviews and meta analysis: 96:37.




DOI: http://dx.doi.org/10.24198/obgynia/v5n1.316

Refbacks

  • There are currently no refbacks.





     
       

Creative Commons License
Indonesian Journal of Obstetrics & Gynecology Science is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
  Web Analytics
  View My Stat