A Case-control Study Of The Risk Factors For Endometrial Polyp Malignancy In Perimenopausal Women

Purpose:1.To study the malignant rate of endometrial polyps in patients of different ages.2.To study the risk factors of endometrial polyp and malignant transformation in perimenopausal patients Methods:From January 2017 to January 2020,1132 patients with endometrial polyps were selected for surgery in Xinjiang Uygur Autonomous Region People’s Hospital,and specimens were sent for pathological examination.According to age and menopausal status,the patients were divided into 336 cases in the <40 year old group,488 cases in the perimenopausal group,and 308 cases in the postmenopausal group.Univariate and multivariate Logistic regression were used to analyze the risk factors of endometrial polyp and endometrial polyp malignancy in perimenopausal patients.Results:1.1132 patients with EPs,age: 23-78 years old,mean age: 45.7±10.8,including 1059 in the benign group and 72 in the malignant group,the overall malignant change rate was 6.4%.In the group<40 years old,336 patients with EPs were stratified according to age and menopausal status,with an average age of33.6±4.5,330 patients with benign disease and 6 patients with malignant disease,and the malignant change rate was 1.8%.In the perimenopausal group,there were 488 patients with EPs,with an average age of 46.0±6.1,450 benign cases and 38 malignant cases,and the malignant change rate was 7.8%.In the postmenopausal group,there were 308 patients with EPs,with an average age of 58.6±7.3,280 benign patients and 28 malignant patients,and the malignant change rate was 9.1%.The malignant change rate of perimenopausal group and postmenopausal group was higher than that of < 40 years old group(7.8% vs1.8%,9.1% vs 1.8%,both P < 0.017).However,there was no statistical difference in the malignant change rate of perimenopausal group and postmenopausal group.2.Univariate analysis showed that the adverse effects of EPs included EMs、AUB、tamoxifen、obesity、hypertension、perimenopause and menopause.Multivariate Logistic regression analysis was performed on the above factors,The results showed that AUB(OR: 2.897,95%CI: 1.613-5.205),obesity(OR: 1.856,95%CI: 1.018-3.187),perimenopause(OR: 5.136,95%CI: 2.091-12.617),menopause(OR: 6.474,95%CI:2.486-16.862)were risk factors for malignant EPs(P<0.05).3.Univariate analysis showed that the factors affecting perimenopausal EPs malignant change included AUB and obesity.Multivariate Logistic regression analysis was performed on the above factors,and the results showed that AUB(OR: 2.746,95%CI: 1.147-6.572),obesity(OR: 2.516,95%CI:1.231-5.144)were risk factors for perimenopausal malignant EPs(P<0.05).Conclusion:1.Compared with < 40 years old group,perimenopausal and postmenopausal EPs malignant change rate was higher.2.AUB 、 obesity 、 perimenopause and menopause were all risk factors for EPs malignant transformation.3.AUB and obesity were the risk factors for perimenopausal EPs malignant transformation,and no other independent risk factors were found for perimenopausal EPs malignant transformation.