Endometrial Hyperplasia with Conservative Treatment Using the Progestin or EP Agents, Compared to Cases that Worsen during Observation

A total of 157 patients were included in this study, comprising 147 with simple Endometrial Hyperplasia (EH) and 10 with complex EH. All patients treated cyclically with progestin or Estrogen-Progestin (EP) exhibited regression of EH after 3 or 4 treatment courses. The relapse rate in patients treated cyclically with progestin was significantly lower than that in those treated with EP for simple EH (P < 0.01). Five cases progressed to EIN over lesions in the 43 follow-up cases of simple EH, and two progressed to those lesions in the five follow-up cases of complex EH, respectively. Loss of PTEN expression was observed in relapse cases, suggesting a potential association with relapse. For EH without atypia, particularly in PTEN-null (+) cases, conservative treatment with progestin or EP is recommended to prevent progression to endometrial carcinoma.