Clinical factors and malignancy in endometrial polyps. Analysis of 1027 cases

Ricciardi, Enzo; Vecchione, Andrea; Marci, Roberto; Schimberni, Mauro; Frega, A; Maniglio, Paolo; Caserta, Donatella; Mangino, Massimo

doi:10.1016/j.ejogrb.2014.10.021

Cited by 33 publications

(21 citation statements)

References 21 publications

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“…Most of these patients were in the postmenopausal period. Similarly, in different studies, the risk of malignancy in endometrial polyps during the postmenopausal period was greater [13][14][15][16][17] . But in a study by Çakmak et al, 5 no malignancy was detected in histopathological examination of endometrial polyps.…”

Section: Discussionmentioning

confidence: 99%

Histopathological evaluation of endometrial sampling in different age groups - 1374 cases

Azatçam¹,

Altun²,

Usta³

2017

MMJ

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Section: Discussionmentioning

confidence: 99%

Histopathological evaluation of endometrial sampling in different age groups - 1374 cases

Azatçam¹,

Altun²,

Usta³

2017

MMJ

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“…Even though approximately 95% of endometrial polyps are benign,resection of endometrial polyps is recommended to rule out malignancy ( 1 , 5 ) . The risk of malignancy and the presence of abnormal uterine bleeding increases in the postmenopausal period ( 1 , 26 , 27 , 28 ) . Histopathologic examinations of endometrial polyps provide the selection of optimal treatment methods in patients with both endometrial polyps and uterine fibroids.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of endometrial polyps coexisting with uterine fibroids and associated factors

Kinay

et al. 2016

tjod

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Objective:The aim of the study was to investigate the prevalence of endometrial polyps in patients with uterine fibroids and associated factors of coexistence of these two pathologies.Materials and Methods:The medical records of 772 patients who underwent hysterectomy because of uterine fibroids were retrospectively reviewed. Patients were divided into two groups according to the presence of endometrial polyps in the histopathologic examination. Demographic, clinical and histopathologic findings of the patients with and without endometrial polyps were compared. Student’s t-test, Mann-Whitney U test, Pearson’s Chi-square test, and logistic regression analysis were used for statistical analysis.Results:The prevalence of the endometrial polyps in uterine fibroid cases was found 20.1% (n=155). Age ≥45 years (odds ratio [OR] 1.61; 95% confidence interval [CI]: [1.06-2.44]; p=0.014), presence of hypertension (23.9% vs. 17.5%; p=0.047), endometrial hyperplasia (OR 4.00; 95% CI: [1.92-8.33]; p<0.001) and cervical polyps (OR 3.13; 95% CI: [1.69-5.88]; p<0.001) were significantly associated with the coexistence of endometrial polyps and uterine fibroids. Endometrial polyps were more common in patients with ≥2 fibroids (p=0.023) and largest fibroid <8 cm (p=0.009). A negative correlation was found between condom use and endometrial polyps (8.1% vs. 3.9%; p=0.044).Conclusions:The prevalence of the endometrial polyps coexisting with uterine fibroids was 20.1%. Age, hypertension, endometrial hyperplasia, cervical polyps, and number of fibroids were positively correlated; condom use and size of largest fibroid were negatively correlated with the coexistence of these two pathologies.

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“…2,24,40 Some studies have shown that despite being significantly related to EPs, hypertension, obesity, and diabetes lose significance when multivariate logistic regression adjusted for age is performed, indicating that postmenopausal status and advancing age are the only independent risk factors for malignancy of polyps. [41][42][43] Thus, given that no reliable clinical parameters are available, and that the accuracy of endometrial biopsies for diagnosing focal intrauterine lesions is low, the removal of EPs larger than one-third of the uterine cavity is recommended in elderly patients (>60 years) and in those with postmenopausal bleeding who are at an increased risk of malignancy. 17,40,43 Patients with risk factors for malignancy may be considered at intermediate risk and should be appropriately followed up according to each center's routine.…”

Section: Discussionmentioning

confidence: 99%

“…[41][42][43] Thus, given that no reliable clinical parameters are available, and that the accuracy of endometrial biopsies for diagnosing focal intrauterine lesions is low, the removal of EPs larger than one-third of the uterine cavity is recommended in elderly patients (>60 years) and in those with postmenopausal bleeding who are at an increased risk of malignancy. 17,40,43 Patients with risk factors for malignancy may be considered at intermediate risk and should be appropriately followed up according to each center's routine. To minimize costs, outpatient excisional biopsy of smaller polyps should be performed using techniques that permit the complete removal of the entire lesion such as the grasp technique, and the cases of polyps larger than the cervical ostium and diffuse polyposis should undergo removal with an operative resectoscope.…”

Section: Discussionmentioning

confidence: 99%

The value of hysteroscopic biopsy in the diagnosis of endometrial polyps

Dias

Bueloni-Dias

Elias

et al. 2016

Womens Health (Lond Engl)

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Several studies have demonstrated that the combination of hysteroscopy with endometrial biopsy is more accurate in differentiating endometrial polyps from endometrial hyperplasia and cancer. However, blind biopsy not always confirms hysteroscopic findings due to high rates of inadequate or insufficient material. The objective of this clinical, prospective, and comparative study was to establish a correlation between the histological results of office-based endometrial biopsies (hysteroscopically guided and blind) with the surgical polypectomy specimens. We evaluated 82 patients with hysteroscopic diagnosis of endometrial polyp, who randomly underwent hysteroscopically guided biopsy or blind biopsy, referred for surgical resection. A total of 36 women (43.9%) underwent hysteroscopically guided biopsy and 46 women (56.1%) underwent blind biopsy. The sensitivity of hysteroscopically guided biopsy for the diagnosis of endometrial polyps ranged between 35.3 and 36.8%, when carried out at the apex and base of the lesion, compared with 29.2% for blind biopsy. Specificity was 33.3, 50, and 60%, respectively, for each biopsy. The positive predictive values were 75, 77.8, and 87.5%, and negative predictive values were 8.3, 14.3, and 8.1% respectively, compared with surgical polypectomy specimens. The office-based endometrial biopsies had low diagnostic accuracy for endometrial polyps compared with surgical polypectomy specimens.

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Clinical factors and malignancy in endometrial polyps. Analysis of 1027 cases

Cited by 33 publications

References 21 publications

Histopathological evaluation of endometrial sampling in different age groups - 1374 cases

Histopathological evaluation of endometrial sampling in different age groups - 1374 cases

Prevalence of endometrial polyps coexisting with uterine fibroids and associated factors

The value of hysteroscopic biopsy in the diagnosis of endometrial polyps

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