Clinic and histologic characteristics of endometrial polyps
Keywords:
endometrial polyps, endometrial cancer, abnormal uterine bleeding, risk factors, hysteroscopyAbstract
Background: The prevalence of endometrial polyps (EP) is high (25 %), but the risk of malignancy low. Women are often asymptomatic. More EP are being diagnosed with the use of transvaginal ultrasound scanning. The purpose of this study was to estimate the incidence of symptomatic and asymptomatic EP and determine whether clinical risk factors and symptoms can predict its histopathological characteristics.
Methods: Retrospective study of 271 women with removed EP in the years 2001–2006 was done. 53.1 % patients underwent operative histeroscopy, 46.9 % uterine curettage. Clinical data were obtained from patients’ medical reports. EPS were subdivided groups as symptomatic A and asymptomatic B; benign (hyperplastic without atypia) and malignant (hyperplastic with atypia, cancerous). Statistical analysis was performed.
Results: In 185 patients (68.3 %) EP were symptomatic, in 86 (31.7 %) asymptomatic. In group A 2 hyperplastic EP without atypia (0.74 %), one hyperplastic EP with atypia (0.37 %) and one cancerous EP (0.37 %) were found. In group B all were benign. Pacient age, menopausal status (p < 0.01, negative correlation) and hypertension (p < 0.05, negative correlation) were associated with symptoms significantly. Hypertension showed a significant association with malignant EP (p < 0.05).
Conclusions: The incidence of malignancy is low. Symptoms were correlated with age, in postmenopausal women more likely asymptomatic and characteristically related to hypertension which is an important risk factor with malignant degeneration of EP. Asymptomatic EP were all benign but not significantly. Hystopathology remains the gold standard. Its removal (hysteroscopic) would be a suitable rationale, especially in hypertensive women.
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