Department of Gynecology and Obstetrics, E. Wolfson Medical Center, Holon, Israel.
Gynecol Obstet Invest. 2010;70(2):107-12. doi: 10.1159/000298767. Epub 2010 Mar 20.
To assess the frequency of premalignant and malignant endometrial polyps in symptomatic and asymptomatic women.
Retrospective registration of 1,124 patients who underwent hysteroscopic resection of endometrial polyps. Patient characteristics included age, menopausal status, presence or absence of symptoms, and use of hormonal medication. Histological diagnoses and complications were also analyzed.
641 (57%) of 1,124 women with endometrial polyps were postmenopausal and 483 (43%) premenopausal. Abnormal uterine bleeding was reported by 548 women: 226 (49%) postmenopausal and 322 (51%) premenopausal. 576 (51%) women were asymptomatic. There were 16 patients with malignancy or premalignant conditions among the symptomatic patients (2.7%) compared to 7 such patients among the asymptomatic patients (1.3%; p = 0.17). Pathologic evaluation disclosed 7 cases of malignancy and 4 cases of atypical hyperplasia among bleeding postmenopausal women (11/263, 4%) and 2 malignancies and 3 cases of hyperplasia with atypia among asymptomatic postmenopausal women (5/378, 1.3%).
We found premalignancy and malignancy in each patient group - pre- and postmenopausal, as well as symptomatic and asymptomatic. We recommend removal of any verified endometrial polyp.
评估有症状和无症状妇女中良性和恶性子宫内膜息肉的发生率。
回顾性登记了 1124 名接受宫腔镜子宫内膜息肉切除术的患者。患者特征包括年龄、绝经状态、有无症状以及是否使用激素药物。还分析了组织学诊断和并发症。
在 1124 名患有子宫内膜息肉的女性中，有 641 名（57%）绝经后和 483 名（43%）绝经前。548 名妇女报告有异常子宫出血：226 名（49%）绝经后和 322 名（51%）绝经前。576 名（51%）妇女无症状。在有症状的患者中，有 16 名患者患有恶性肿瘤或癌前病变（2.7%），而在无症状患者中，有 7 名患者患有恶性肿瘤或癌前病变（1.3%；p=0.17）。病理评估显示，在出血性绝经后妇女中（263 例中有 11 例，4%）有 7 例恶性肿瘤和 4 例非典型增生，在无症状绝经后妇女中（378 例中有 5 例，1.3%）有 2 例恶性肿瘤和 3 例非典型增生伴增生。
我们在每个患者组——绝经前和绝经后，以及有症状和无症状的患者中都发现了癌前病变和恶性肿瘤。我们建议切除任何已证实的子宫内膜息肉。
