Endometrial Polyps In Asymptomatic Postmenopausal Women :Factors Associated With Premalignant/ Maligancy

Objective: Retrospective analysed the clinical data of 161 patients with endometrial polyps,and evaluate the prevalence of premalignant and malignant polyps in asymptomatic postmenopausal women. Analyze the factors associated with malignancy of endometrial polyps in asymptomatic postmenopausal women,further explore the appropriate treatment indications of endometrial polyps in asymptomatic postmenopausal women,and provide a new train of thought of treatment for endometrial polyps in postmenopausal women.Materials and Methods: Retrospective analysed the clinical data of 161 postmenopausal patients who underwent hysteroscopic polypectomy at the Department of the First Affiliated of Dalian Medical University between June 1st,2004 and June 30,2014. According to having abnormal uterine bleeding or not, divided all the cases into two groups: asymptomatic group(81 cases) and symptomatic group(80 cases).According to the final pathologic report, classified the polyps which were removed by hysteroscopic polypectomy as benign(endometrial poly, polyp with simple/ complex hyperplasia without atypia) or premalignant/malignant(polyps with hyperplasia and atypia,endometrial carcinoma).In asymptomatic group, 76 cases were benign and 5 cases were premalignant/malignant; in symptomatic group, 71 cases were benign and 9 cases were premalignant/malignant.To evaluate the prevalence of premalignant and malignant polyps in asymptomatic postmenopausal women, and compare the prevalence of premalignant and malignant polyps with the cohort of symptomatic postmenopausal patients. Analyze the factors including age, years of menopause, parity,obesity, the number and size of polyp, blood flow presented by ultrasound, hypertension, diabetes, hormone therapy, use of tamoxifen,associated with premalignant/malignancy of endometrial polyps in asymptomatic and symptomatic postmenopausal women respectively.Results: In all 161 postmenopausal patients with endometrial polyps who underwent hysteroscopic polypectomy,147 cases(91.3%)were benign and 14 cases(8.7%)were premalignant/malignant. In the asymptomatic group(81 cases), 76 cases(93.8%) were benign and 5 cases(6.2%)were premalignant/malignant; In the symptomatic group(80 cases), 71 cases(88.8%) were benign and 9 cases(11.2%)were premalignant/malignant. Compare the prevalence of premalignant and malignant polyps between asymptomatic group and symptomatic group, and no statistically significant has been found. Analyze the factors associated with premalignant/malignancy of endometrial polyps in asymptomatic and symptomatic postmenopausal women respectively.The univariate analysis : obesity, diabetes and blood flow presented by ultrasound were statistically significant. And put the three factors into multivariable Logistic regression analysis(Backward:Wald), the result indicates: obesity(BMI≥28kg/m2) and blood flow presented by ultrasound were statistically significant, and they are the independent risk factors associated with premalignant/malignancy of endometrial polyps in asymptomatic postmenopausal women. However, no statistically significant has been found between age, years of menopause, parity,the number and size of polyp, hypertension, diabetes, hormone therapy, use of tamoxifen and premalignant/malignancy of endometrial polyps in postmenopausal women.Conclusion:1. Compare the prevalence of premalignant and malignant polyps between asymptomatic group and symptomatic group, and no statistically significant has been found,therefore asymptomatic postmenopausal women should pay attention when finding endometrial polyps accidently;2. Obesity(BMI≥28kg/m2) and blood flow presented by ultrasound are the independent risk factors associated with premalignant/malignancy of endometrial polyps in postmenopausal women;3. Age, years of menopause, parity,the number and size of polyp, hypertension, diabetes, hormone therapy, use of tamoxifen have noting to do with premalignant /malignancy of endometrial polyps in postmenopausal women.