Opportunities and Risk Factors for Premalignant and Malignant Transformation of Endometrial Polyps: Management Strategies
Received 9 September 2009; accepted 30 October 2009.
Abstract
Study Objective
To estimate the prevalence of benign, premalignant, and malignant endometrial polyps and the associated clinical risk factors for premalignant and malignant endometrial polyps.
Design
Retrospective study (Canadian Classification II-3).
Setting
Teaching hospital.
Patients
Seven hundred sixty-six patients with endometrial polyps.
Interventions
Hysteroscopic removal of endometrial polyps.
Measurements and Main Results
Patient clinical data were identified and analyzed. Frequency of premalignant and malignant histopathologic features in endometrial polyps was calculated. Clinical risk factors for premalignant and malignant endometrial polyps were analyzed. Endometrial polyps were histologically benign in most patients (96.21%). Hyperplasia with atypia in a polyp (premalignant polyp) was found in 3.26% of patients, and endometrial carcinoma in a polyp (malignant polyp) was detected in only 0.52 % of patients. Independent variables that were significantly related to premalignant and malignant polyps (all p <.05) in a binary logistic regression analysis included polyp diameter (odds ratio [OR], 2.93; 95% confidence interval [CI], 1.191–7.20), menopause status (OR, 4.85; 95% CI, 2.09–11.27), and abnormal uterine bleeding (OR, 3.97; 95% CI, 1.71–9.18).
Conclusion
Polyp diameter larger than 1.0cm, menopause status, and abnormal uterine bleeding may increase the risk of premalignant and malignant endometrial polyps.
ABSTRACT