The malignant potential of endometrial polyps
The malignant potential of endometrial polyps
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DOI：
10.1016/j.ejogrb.2004.02.002
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发表时间：
2004-08-10
期刊：
影响因子：
--
通讯作者：
Hagay, Z
中科院分区：
文献类型：
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作者：
Ben-Arie, A;Goldchmit, C;Hagay, Z
目的：确定子宫内膜息肉的癌前病变和恶性病变的可能性，并评估不同的临床参数是否与子宫内膜息肉的恶变有关。研究设计：连续430例宫腔镜检诊断为子宫内膜息肉患者。复习病历、术前阴道超声结果及组织病理学检查结果。进行统计学分析。结果：宫腔镜诊断子宫内膜息肉的准确率为95.7%。在11.4%的病例中，子宫内膜息肉有无异型性增生。在3.3%和3.0%的女性息肉中发现了癌前状态或恶性状态。高龄、绝经状态和大于1.5厘米的息肉与显著的癌前或恶变相关，尽管对恶变的阳性预测价值很低。所有恶性息肉都只在绝经后妇女中被诊断出来。绝经后或不规则阴道出血的存在，并不是息肉恶性的预兆。结论：绝经后合并子宫内膜息肉的妇女发生息肉恶变的风险增加。这些患者，无论是否有症状，都应该通过宫腔镜息肉切除术进行评估。无症状的绝经前患者可观察到息肉小于1.5厘米。(C)2004爱思唯尔爱尔兰有限公司。保留所有权利。
Objectives: To determine the pre-malignant and malignant potential of endometrial polyps and to assess whether different clinical parameters are associated with malignancy in the polyps. Study design: Four hundred and thirty consecutive cases of hysteroscopic diagnosis of endometrial polyp were retrieved. The medical records, preoperative vaginal sonography results and histopathology findings were reviewed. Statistical analysis was performed. Results: Hysteroscopy truly identified endometrial polyps in 95.7% of the cases. In 11.4% cases, hyperplasia without atypia was found in the endometrial polyp. In 3.3 and 3.0% of women pre-malignant or malignant conditions were found in the polyp. Older age, menopause status and polyps larger than 1.5 cm were associated with significant pre-malignant or malignant changes, although the positive predictive value for malignancy was low. All the malignant polyps were diagnosed only in postmenopausal women. The presence of postmenopausal or irregular vaginal bleeding, was not a predictor of malignancy in the polyp. Conclusions: Postmenopausal women with endometrial polyps are at increased risk of malignancy in the polyp. Those patients, whether symptomatic or not should be evaluated by hysteroscopic resection of the polyps. Asymptomic premenopausal patients with polyps smaller than 1.5 cm can be observed. (C) 2004 Elsevier Ireland Ltd. All rights reserved.