The Expression Of Aromatase In The Endometrial Polyps In Postmenopausal Women And Clinical Analysis Of 178 Cases

Part one The expression of aromatase in the Endometrial Polyps in Postmenopausal WomenObjective: To investigate the pathogenesis of the endometrial polyps in postmenopausal women.Methods: To apply case-control study method into this observational study,all the person studied were menopausal.To select 30 cases with endometrial polyps as the experimental group, and we took the polyps as the experiment group 1, and got atrophy endometrial tissue which was remote from the polyps as the experimental group2. In the control group 30 were selected and the endometrium was normal. The experimental group underwent hysteroscopic resection of polyps, all of which were benign polyps histologically; the control group were postmenopausal women who had been taken IUD out of the uterus under hysteroscopic,and pathological examinations had already confirmed postmenopausal atrophic endometrium. All patients from experimental and control groups had the serum test of follicle stimulating hormones and serum estrogen,and the later was selected as one of the observed indicators. The expression of aromatase in polyps were determined by immunohistochemical methods.Analyzed the picture, and the average optical density value was selected as comparative indicators.Results: The serum follicle stimulating hormones was 56.43-117.6 m IU/ml in polyps group,in non-polyps group was46.51-105.6m IU/ml,both above 40 m IU/ml. Peripheral serum estrogen level between control and experimental group had no statistic difference,the estrogen level was(15.88±1.22)pg·m L-1 and(16.09±1.37)pg·m L-1respectively(p=0.52,t=0.64).The mean optical density value of aromatase in polyps,tissue remote from polyps and normal endometrium was(0.1013±0.0007),(0.0251±0.0027) and(0.0245±0.0004), respectively. According to the significance level of α= 0.05, the expression of aromatase in polyps was higher than in the endometriumremote from polyps,had significant difference statistically(p=0.000,t=146.9).The expression of aromatase in polyps tissue was higher than in the normal endometrium,and had significant difference statistically(p=0.000,t=488.5);The expression of aromatase in the endometrium remote from polyps was higher than in the normal endometrium, but had no statistic difference(p=0.24,t=1.18).Conclusion:1. The formation of postmenopausal endometrial polyps does not depend on the increase of the serum estrogen level;2. The over expression of aromatase in endometriun lead to local estrogen synthesis may play a critical role in the formation of postmenopausal endometrial polyps.Part two Clinical analysis of 178 cases of postmenopausal endometrial polypsObjective: To compare the occurrence between benign and malignant endometrial polyps in patients age,obesity and complications,in order to find which clinical characteristics were more likely to exist in the malignant endometrial polyps.Wish to do some help to the obstetricians.Methods: 178 postmenopausal endometrial polyps cases were collection since March2012 to May 2013 in our hospital. 169 cases were benign,take up 94.9% proportion,nine cases of malignancy, accounting for 5.1% of the total( 9/178). Age, vaginal bleeding, obesity( BMI ≥25kg / m2) and the incidence of complications were compared.Statistic methods:chi-square test. Because the expectation frequent between1 to 5,so continuous correction of the chi-square test were selected finally.Results: Selected 60 years old as demarcation point,3 cases in malignant group and benign group of 74 cases, the two groups compare the ratio had no significant difference statistically(x2 = 0.074, p = 0.781), it is means that in both benign and malignant endometrial polyps the proportion of those older than 60 years has no difference;Vaginal bleeding occurs in malignant polyp group, for 7 cases, benign polyp group of52 cases,the ratio of vaginal bleeding was significantly difference(x2 = 6.532, p =0.011), malignant polyps were more likely to accompany vaginal bleeding.The number of hypertension of malignant group were 4 cases, 31 cases with hypertensive in benign group.The ratio was not statistically significant(x2 = 2.218, p = 0.136);Five cases of diabetes in malignant and 23 were in benign, the two groups ratio had no statistic difference(x2 = 8.398, p = 0.004),diabetes in the malignant group was more common.In malignant group there was seven cases of hyperlipidemic,43 cases were in benign group, the ratio between the two groups was different statistically(x2 = 9.140, p =0.003), we found that malignant polyps were more likely to be present in hyperlipidemia.Obesity in the malignant group for 8 example, in the benign group were 70 cases, two groups to compare, the difference was significant(x2= 6.012, p =0.011), the malignant was more common in obese persons.conclusion:1.Postmenopausal endometrial polyps with vaginal bleeding may be more prone to malignant transformation;2.Postmenopausal endometrial polyps with obesity,hyperlidemia and diabetes may be more prone to malignant transformation.