Cargando…
Clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients
OBJECTIVE: Morular metaplasia (MM) is a benign epithelial metaplasia that sometimes appears in atypical endometrial hyperplasia (AEH) and endometrioid endometrial carcinoma (EEC). However, the clinical implications of MM for fertility-preserving treatment in AEH and EEC patients are unclear. This st...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9470654/ https://www.ncbi.nlm.nih.gov/pubmed/35246715 http://dx.doi.org/10.1007/s00404-021-06382-3 |
_version_ | 1784788891104968704 |
---|---|
author | Wu, Pengfei Lv, Qiaoying Guan, Jun Shan, Weiwei Chen, Xiaojun Zhu, Qin Luo, Xuezhen |
author_facet | Wu, Pengfei Lv, Qiaoying Guan, Jun Shan, Weiwei Chen, Xiaojun Zhu, Qin Luo, Xuezhen |
author_sort | Wu, Pengfei |
collection | PubMed |
description | OBJECTIVE: Morular metaplasia (MM) is a benign epithelial metaplasia that sometimes appears in atypical endometrial hyperplasia (AEH) and endometrioid endometrial carcinoma (EEC). However, the clinical implications of MM for fertility-preserving treatment in AEH and EEC patients are unclear. This study investigated the clinical features and impact of MM on the efficacy of fertility-preserving treatment. METHODS: We retrospectively studied 427 AEH and EEC patients who received fertility-preserving treatment. Clinical features, treatment efficacy, and onco-fertility results were compared between patients with and without MM. RESULTS: MM appeared in 147 of 427 (34.4%) patients. Among them, 49 (33.3%) had MM only before treatment (BEF group), 32 (21.8%) had sustained MM before and during treatment (SUS group), and 66 (44.9%) had MM only during treatment (DUR group). The BEF group had a higher 12-month CR rate (98.0% vs 85.7%, p = 0.017) and shorter therapeutic duration to achieve CR (4.0 vs 5.7 months, p = 0.013) than the non-MM group had. In comparison with the non-MM group, the SUS and DUR groups had a lower CR rate after 7 months of treatment (SUS vs non-MM, 37.5% vs 61.1%, p = 0.010; DUR vs non-MM 33.3% vs. 61.1%, p < 0.001), and a longer median therapeutic duration to achieve CR (SUS vs non-MM, 7.6 vs. 4.0 months, p = 0.037; DUR vs non-MM, 7.9 vs. 4.0 months, p < 0.001). CONCLUSION: Appearance of MM only before treatment was positively correlated with outcome of fertility-preserving treatment, while sustained MM or appearance of MM only during treatment implied poorer outcome of fertility-preserving treatment in AEH and EEC patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00404-021-06382-3. |
format | Online Article Text |
id | pubmed-9470654 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-94706542022-09-15 Clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients Wu, Pengfei Lv, Qiaoying Guan, Jun Shan, Weiwei Chen, Xiaojun Zhu, Qin Luo, Xuezhen Arch Gynecol Obstet Gynecologic Oncology OBJECTIVE: Morular metaplasia (MM) is a benign epithelial metaplasia that sometimes appears in atypical endometrial hyperplasia (AEH) and endometrioid endometrial carcinoma (EEC). However, the clinical implications of MM for fertility-preserving treatment in AEH and EEC patients are unclear. This study investigated the clinical features and impact of MM on the efficacy of fertility-preserving treatment. METHODS: We retrospectively studied 427 AEH and EEC patients who received fertility-preserving treatment. Clinical features, treatment efficacy, and onco-fertility results were compared between patients with and without MM. RESULTS: MM appeared in 147 of 427 (34.4%) patients. Among them, 49 (33.3%) had MM only before treatment (BEF group), 32 (21.8%) had sustained MM before and during treatment (SUS group), and 66 (44.9%) had MM only during treatment (DUR group). The BEF group had a higher 12-month CR rate (98.0% vs 85.7%, p = 0.017) and shorter therapeutic duration to achieve CR (4.0 vs 5.7 months, p = 0.013) than the non-MM group had. In comparison with the non-MM group, the SUS and DUR groups had a lower CR rate after 7 months of treatment (SUS vs non-MM, 37.5% vs 61.1%, p = 0.010; DUR vs non-MM 33.3% vs. 61.1%, p < 0.001), and a longer median therapeutic duration to achieve CR (SUS vs non-MM, 7.6 vs. 4.0 months, p = 0.037; DUR vs non-MM, 7.9 vs. 4.0 months, p < 0.001). CONCLUSION: Appearance of MM only before treatment was positively correlated with outcome of fertility-preserving treatment, while sustained MM or appearance of MM only during treatment implied poorer outcome of fertility-preserving treatment in AEH and EEC patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00404-021-06382-3. Springer Berlin Heidelberg 2022-03-04 2022 /pmc/articles/PMC9470654/ /pubmed/35246715 http://dx.doi.org/10.1007/s00404-021-06382-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Gynecologic Oncology Wu, Pengfei Lv, Qiaoying Guan, Jun Shan, Weiwei Chen, Xiaojun Zhu, Qin Luo, Xuezhen Clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients |
title | Clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients |
title_full | Clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients |
title_fullStr | Clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients |
title_full_unstemmed | Clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients |
title_short | Clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients |
title_sort | clinical implications of morular metaplasia in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial carcinoma patients |
topic | Gynecologic Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9470654/ https://www.ncbi.nlm.nih.gov/pubmed/35246715 http://dx.doi.org/10.1007/s00404-021-06382-3 |
work_keys_str_mv | AT wupengfei clinicalimplicationsofmorularmetaplasiainfertilitypreservingtreatmentforatypicalendometrialhyperplasiaandearlyendometrialcarcinomapatients AT lvqiaoying clinicalimplicationsofmorularmetaplasiainfertilitypreservingtreatmentforatypicalendometrialhyperplasiaandearlyendometrialcarcinomapatients AT guanjun clinicalimplicationsofmorularmetaplasiainfertilitypreservingtreatmentforatypicalendometrialhyperplasiaandearlyendometrialcarcinomapatients AT shanweiwei clinicalimplicationsofmorularmetaplasiainfertilitypreservingtreatmentforatypicalendometrialhyperplasiaandearlyendometrialcarcinomapatients AT chenxiaojun clinicalimplicationsofmorularmetaplasiainfertilitypreservingtreatmentforatypicalendometrialhyperplasiaandearlyendometrialcarcinomapatients AT zhuqin clinicalimplicationsofmorularmetaplasiainfertilitypreservingtreatmentforatypicalendometrialhyperplasiaandearlyendometrialcarcinomapatients AT luoxuezhen clinicalimplicationsofmorularmetaplasiainfertilitypreservingtreatmentforatypicalendometrialhyperplasiaandearlyendometrialcarcinomapatients |