The Journal of Minimally Invasive Gynecology
Volume 17, Issue 1 , Pages 53-58, January 2010

Opportunities and Risk Factors for Premalignant and Malignant Transformation of Endometrial Polyps: Management Strategies

  • Jian-Hua Wang, MD

      Affiliations

    • Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
    • ,
  • Jin Zhao, MD

      Affiliations

    • Xiaoshan District First People's Hospital of Hangzhou, Hangzhou, Zhejiang, China
    • ,
  • Jun Lin, MD

      Affiliations

    • Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
    • Corresponding Author InformationCorresponding author: Jun Lin, MD, Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.

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.

Keywords: Endometrial cancer, Endometrial polyps, Hyperplasia, Hysteroscopy, Risk factors, Uterine bleeding

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 The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

PII: S1553-4650(09)01237-0

doi:10.1016/j.jmig.2009.10.012

The Journal of Minimally Invasive Gynecology
Volume 17, Issue 1 , Pages 53-58, January 2010

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