Tang Zhijian, Zhou Rong, Bao Dongmei, Liu Chen, Wei Lihui
Department of Gynecology, Peking University People's Hospital, Beijing 100044, China.
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Zhonghua Fu Chan Ke Za Zhi. 2014 Mar;49(3):204-7.
To investigate the clinicopathologic characteristics of premalignant and malignant endometrial polyps (EP) in premenopausal and postmenopausal women.
A retrospective analysis was conducted in 42 cases of premalignant and malignant EP from 1993 to 2012. Polyps were classified into premenopausal (group A, 10 cases) and menopausal (group B, 32 cases), including 26 cases of endometrioid adenocarcinoma, 4 of clear cell carcinoma, 9 of serous adenocarcinoma, and 3 of atypical hyperplasia.
The prevalence rate of premalignant and malignant EP was 1.42% (42/2 965), the prevalence rate of malignancy in postmenopausal and postmenopausal women was 0.48% (10/2 064) and 3.55% (32/901), respectively. The mean size of EP was (1.6 ± 0.8) cm, abnormal uterine bleeding was positive in 90% (38/42) of cases. The EP pathological diagnosis showed all were endometrioid adenocarcinoma in group A, while there were 4 of clear cell carcinoma, 9 of serous adenocarcinoma in group B. The mean size of EP was (1.1 ± 0.6) and (1.7 ± 0.9) cm in group A and B respectively (P < 0.05). According to immunohistochemistry, all cases of group A were ER positive, but 41% (11/27) of group B were ER negative (P = 0.059). The PR positive rate was 8/9 and 56% (15/27) in group A and B, respectively (P = 0.169).
The risk of the EP malignancy rate is higher, while ER, PR positive rate are lower in postmenopausal women. Postmenopausal EP, especially accompanied by abnormal uterine bleeding and large polyps should be removed as soon as possible.
探讨绝经前和绝经后妇女子宫内膜息肉（EP）恶变前后的临床病理特征。
对1993年至2012年间42例恶变前后的EP进行回顾性分析。息肉分为绝经前（A组，10例）和绝经后（B组，32例），包括26例子宫内膜样腺癌、4例透明细胞癌、9例浆液性腺癌和3例非典型增生。
恶变前后EP的患病率为1.42%（42/2965），绝经前和绝经后妇女的恶变率分别为0.48%（10/2064）和3.55%（32/901）。EP的平均大小为（1.6±0.8）cm，90%（38/42）的病例子宫异常出血呈阳性。EP病理诊断显示A组均为子宫内膜样腺癌，而B组有4例透明细胞癌、9例浆液性腺癌。A组和B组EP的平均大小分别为（1.1±0.6）cm和（1.7±0.9）cm（P<0.05）。免疫组化显示，A组所有病例ER均为阳性，但B组41%（11/27）为ER阴性（P=0.059）。A组和B组PR阳性率分别为8/9和56%（15/27）（P=0.169）。
EP恶变风险较高，绝经后妇女ER、PR阳性率较低。绝经后EP，尤其是伴有子宫异常出血和息肉较大者应尽早切除。
