Meng Qingyou, Ge Na, Fan Yulong, Li Liang
Health Management Center, Jinan Maternity and Child Care Hospital Jinan 250000, Shandong, China.
Department of Ultrasound, Pingyin Hospital of Traditional Chinese Medicine Jinan 250400, Shandong, China.
Am J Transl Res. 2024 Jul 15;16(7):3055-3063. doi: 10.62347/GFIU8015. eCollection 2024.
To examine the ultrasonic changes in postmenopausal endometrial polyps and analyze factors related to their malignant transformation.
This retrospective study analyzed clinical data from 200 postmenopausal patients with endometrial polyps treated at Jinan Maternity and Child Care Hospital and Pingyin Hospital of Traditional Chinese Medicine from December 2020 to December 2023. All patients underwent pathological biopsies to diagnose the nature of the endometrial polyps. This study compared the clinical and ultrasonic imaging features of these patients and analyzed factors influencing the malignant transformation of postmenopausal endometrial polyps.
Pathological findings classified 160 patients (80.00%) into the benign group and 40 patients (20.00%) into the malignant group. Significant differences were noted in endometrial thickness, polyp diameter, heterogeneity of lesion echogenicity, and vascularization between the groups (all P<0.05). The malignant group exhibited notably higher blood flow (Grade II+III constituted 70.00% compared to 29.38% in the benign group, P<0.05). The time average velocity (TAV), pulse index (PI), and resistance index (RI) were significantly lower in the malignant group (all P<0.05). The area under curve (AUC) values for TAV, PI, and RI in diagnosing malignant endometrial polyps were 0.754, 0.713, and 0.771, respectively. Increased body mass index (BMI), irregular premenopausal menstruation, and ≥2 occurrences of postmenopausal bleeding were identified as risk factors for malignant transformation (all P<0.05). These six indicators were used to create a predictive model for malignant transformation, achieving an AUC of 0.942.
Malignancy in postmenopausal endometrial polyps is uncommon, yet distinct differences exist in the transvaginal color Doppler ultrasound characteristics between benign and malignant cases. Factors such as increased BMI, irregular premenopausal menstruation, and ≥2 occurrences of postmenopausal bleeding significantly contribute to the risk of malignant transformation. These findings, combined with ultrasound features, provide a robust basis for screening and monitoring these patients.
探讨绝经后子宫内膜息肉的超声变化，并分析其恶变相关因素。
本回顾性研究分析了2020年12月至2023年12月在济南市妇幼保健院和平阴县中医医院接受治疗的200例绝经后子宫内膜息肉患者的临床资料。所有患者均接受病理活检以诊断子宫内膜息肉的性质。本研究比较了这些患者的临床和超声影像学特征，并分析了影响绝经后子宫内膜息肉恶变的因素。
病理结果将160例患者（80.00%）分为良性组，40例患者（20.00%）分为恶性组。两组在子宫内膜厚度、息肉直径、病变回声不均匀性和血管化方面存在显著差异（均P<0.05）。恶性组的血流明显更高（Ⅱ级+Ⅲ级占70.00%，而良性组为29.38%，P<0.05）。恶性组的时间平均流速（TAV）、搏动指数（PI）和阻力指数（RI）明显更低（均P<0.05）。TAV、PI和RI诊断恶性子宫内膜息肉的曲线下面积（AUC）值分别为0.754、0.713和0.771。体重指数（BMI）增加、绝经前月经不规律以及绝经后出血≥2次被确定为恶变的危险因素（均P<0.05）。这六个指标用于建立恶变预测模型，AUC为0.942。
绝经后子宫内膜息肉恶变并不常见，但良性和恶性病例的经阴道彩色多普勒超声特征存在明显差异。BMI增加、绝经前月经不规律以及绝经后出血≥2次等因素显著增加恶变风险。这些发现结合超声特征，为这些患者的筛查和监测提供了有力依据。
