Clinical Characteristics Of Premalignant/malignant Endometrial Polyps

Objective:Assessment the prevalence of premalignant and malignant polyps in premenopausal and postmenopausal women.Analyze the risk factors associated with malignancy of endometrial polyps to explore the appropriate treatment indications for endometrial polyps and provide a new strategy for endometrial polyps.Materials and Methods:Retrospective analysis of the clinical data of 1847 premenopausal and postmenopausal EPs patients who underwent hysteroscopic polypectomy diagnosed by ultrasound,in the Women’s Hospital School of Medicine Zhejiang University between January 1st,2015 and December 31,2015.The patients were divided into benign EP group and malignant group according to the final pathology.Record clinical data including:age,symptoms,menopause age,height,weight,gravidity,parity,accompanied diseases such as hypertension,diabetes,cervical polyp,hormone-related gynecological diseases(such as uterine fibroids,endometriosis),history of EP,hormone replacement therapy(HRT),ultrasonic examination results and hysteroscopy operation record.To evaluate the prevalence of premalignant and malignant polyps,univariate and multivariate unconditional Logistic Regression Analysis were used to find the risk factors associated with EP malignancy.Results:In all 1847 patients with EP who underwent hysteroscopic polypectomy,1820 cases(98.54%)were benign and 27 cases(1.46%)were premalignant/malignant.Univariate statistical analysis revealed that the following factors were related with the malignancy of EP:age,menopausal status,abnormal uterine bleeding(AUB),hypertension,diabetes,HRT,the number and size of polyp(P<0.05).While age,AUB,HRT and size of polyp had strong relationship with EP malignancy according to multivariate unconditional Logistic Regression Analysis(OR value 1.10,4.01,48.94,1.73 respectively,P<0.05).Menopause age,the period of menopause,body mass index(BMI),gravidity,parity,,cervical polyp,hormone-related gynecological diseases(such as uterine fibroids,endometriosis),history of EP,the site of intrauterine single polyp had no correlation with EP malignancy.Conclusion:The prevalence rate of EP malignancy is 1.46%,Older age,AUB,HRT and large size of single polyp are the independent risk factors associated with premalignant/ma-lignancy of endometrial polyps.Our results suggest that women presenting with these risk factors shoyld undergo hysteroscopic resection of lesions.Because of the low prevalence rate of malignancy in EP and part of polyps may spontaneously regress,people with no risk factors may avoid surgical treatment and expectant management with no intervention may be appropriate.