Baiocchi Gabriela, Manci Natalina, Pazzaglia Michela, Giannone Laura, Burnelli Liliana, Giannone Ettore, Fratini Daniela, Di Renzo Gian Carlo
Department of Gynecology and Obstetrics, Santa Maria della Misericordia University Hospital, Perugia, Italy.
Am J Obstet Gynecol. 2009 Nov;201(5):462.e1-4. doi: 10.1016/j.ajog.2009.05.055. Epub 2009 Jul 26.
Endometrial polyps (EPs) are common pathological lesions in all women. The objective of this study was to evaluate the risk of malignancy of EPs and to investigate whether clinical parameters may predict the histopathologic features of these lesions.
A retrospective study was conducted from January 1995 to December 2006 and all consecutive 1242 cases with clinical EPs were included. The charts of all these women were reviewed and clinical data were related to histopathologic results.
Histologically, polyps were distinguished as benign, premalignant, and malignant. Overall, 95.2% benign polyps, 1.3% premalignant, and 3.5% malignant lesions were detected. When clinical variables were considered, patient age, menopause, presence of abnormal uterine bleeding, and hypertension were statistically significant characteristics related to premalignant and malignant features.
Older menopausal bleeding patients with hypertension are at high risk for premalignant and malignant polyps. Therefore, besides abnormal bleeding symptoms, this kind of patient needs to have the polyps removed.
子宫内膜息肉(EPs)是所有女性常见的病理病变。本研究的目的是评估EPs的恶性风险,并调查临床参数是否可以预测这些病变的组织病理学特征。
对1995年1月至2006年12月进行了一项回顾性研究,纳入了所有连续的1242例临床诊断为EPs的病例。回顾了所有这些女性的病历,并将临床数据与组织病理学结果相关联。
从组织学上看,息肉分为良性、癌前病变和恶性。总体而言,检测到95.2%为良性息肉,1.3%为癌前病变,3.5%为恶性病变。当考虑临床变量时,患者年龄、绝经状态、异常子宫出血的存在以及高血压是与癌前病变和恶性特征相关的具有统计学意义的特征。
绝经后有高血压且有出血症状的老年患者患癌前病变和恶性息肉的风险较高。因此,除了异常出血症状外,这类患者需要切除息肉。