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宫颈息肉:评估常规手术干预的必要性及其与宫颈涂片细胞学和子宫内膜病理学的相关性:一项回顾性研究。

Cervical polyp: evaluating the need of routine surgical intervention and its correlation with cervical smear cytology and endometrial pathology: a retrospective study.

作者信息

Pegu Bhabani, Srinivas Bheemanathi Hanuman, Saranya Thangamuthu Sri, Murugesan Rajeswari, Priyadarshini Thippeswamy Smitha, Gaur Bhanu Pratap Singh

机构信息

Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

出版信息

Obstet Gynecol Sci. 2020 Nov;63(6):735-742. doi: 10.5468/ogs.20177. Epub 2020 Oct 16.

Abstract

OBJECTIVE

To determine the frequency of premalignant and malignant lesions in cervical polyps in order to examine whether cervical polyps need to be removed routinely and also to appraise its association with cervical smear cytology and endometrial pathologies.

METHODS

We retrospectively re-examined the hospital records of 299 cases over a period of 5 years. All patients were segregated into perimenopausal and postmenopausal groups according to their menopausal status. The groups were compared in terms of histological results of cervical polyp biopsy, endometrial pathologies, and cervical smear cytology. Pearson's χ2 test and Fisher's exact test were used for statistical analysis, and a P-value of <0.05 was accepted as statistically significant.

RESULTS

In the histopathological reports of cervical polyps, premalignant lesions were found in 2% of cases, and only 0.3% of malignant lesion was observed in menopausal women. Subsequently, no malignancy was noted in cervical smear cytology for both groups. Premalignant and malignant lesions in endometrial histopathology findings were 1.33% and 0.66%, respectively. There was a statistically significant association between the menopausal status of the patient and cervical smear cytology and endometrial pathology, but the histological findings were not statistically significant in relation to the symptomatic status of the patients.

CONCLUSION

As per the results, we strongly suggest the removal of all cervical polyps with subsequent histological review. The evaluation of cervical smear cytology prior to polypectomy can provide information about its malignancy potential. We believe that along with cervical polypectomy, endometrial sampling should be recommended, especially for postmenopausal women.

摘要

目的

确定宫颈息肉中癌前病变和恶性病变的发生率,以探讨宫颈息肉是否需要常规切除,并评估其与宫颈涂片细胞学及子宫内膜病变的相关性。

方法

我们回顾性复查了5年间299例患者的医院记录。所有患者根据绝经状态分为围绝经期组和绝经后组。比较两组宫颈息肉活检的组织学结果、子宫内膜病变及宫颈涂片细胞学情况。采用Pearson卡方检验和Fisher精确检验进行统计学分析,P值<0.05被认为具有统计学意义。

结果

在宫颈息肉的组织病理学报告中,2%的病例发现有癌前病变,仅0.3%的恶性病变见于绝经后女性。随后,两组宫颈涂片细胞学检查均未发现恶性病变。子宫内膜组织病理学检查中癌前病变和恶性病变分别为1.33%和0.66%。患者的绝经状态与宫颈涂片细胞学及子宫内膜病变之间存在统计学显著相关性,但组织学结果与患者症状状态无统计学显著相关性。

结论

根据结果,我们强烈建议切除所有宫颈息肉并进行后续组织学检查。息肉切除术前评估宫颈涂片细胞学可提供其恶性潜能的信息。我们认为,除宫颈息肉切除外,应建议进行子宫内膜取样,尤其是对于绝经后女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1407/7677067/c0951d575954/ogs-20177f1.jpg

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