Oncological significance of endometrial polyps

The association of endometrial polyps and endometrial neoplasia is still controversial. Our main objectives were to study the frequency, the characteristics and possible associated factors of endometrial neoplasia in a population of 1390 consecutive patients referred for hysteroscopy following ultra...

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Detalles Bibliográficos
Autor: Gambadauro, Pietro
Tipo de recurso: tesis doctoral
Fecha de publicación:2013
País:España
Institución:Universidad de Cantabria (UC)
Repositorio:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglés
OAI Identifier:oai:repositorio.unican.es:10902/28736
Acceso en línea:https://hdl.handle.net/10902/28736
Access Level:acceso abierto
Palabra clave:Endometrial polyps
Endometrial cancer
Endometrial atypia
Hysteroscopy
Transvaginal ultrasound
Pólipos endometriales
Cáncer endometrial
Atipia endometrial
Histeroscopia
Ecografia transvaginal
Descripción
Sumario:The association of endometrial polyps and endometrial neoplasia is still controversial. Our main objectives were to study the frequency, the characteristics and possible associated factors of endometrial neoplasia in a population of 1390 consecutive patients referred for hysteroscopy following ultrasonographic diagnosis of endometrial polyps. Sixteen cases of endometrial neoplasia were diagnosed (1.15%). All the patients had symptoms and fifteen of them were post-menopausal (93.8%). The neoplasia was not confined to the polyp in most of the cases. Patients with a higher risk disease were significantly younger. In a nested case-control study, 64 controls with benign endometrial polyps were compared to the 16 cases of endometrial neoplasia. The cases were significantly older (p<.001) and had a greater BMI (p<.001). Other factors significantly associated with endometrial neoplasia were postmenopausal status and bleeding. At multivariate analysis with logistic regression, the only factors independently associated with endometrial neoplasia were older age (OR 1.102; 95%CI 1.015-1.198) and bleeding (OR 13.7; 95%Cl 1.486-126.278). In conclusion, the prevalence of endometrial neoplasia in patients with an ultrasonographic diagnosis of endometrial polyp is low, and the malignancy is commonly not confined to the polyp. Bleeding and older age are independently associated with neoplasia, and no case of cancer was found in asymptomatic women.