| Objective:To apply Meta-evidence-based analysis of the correlation between asymptomatic endometrial polyps and endometrial lesions in menopausal women with endocrine hormone-related diseases to further improve the predictive value of endometrial lesions in menopausal women with a history of endocrine hormone-related diseases,so as to better guide the diagnosis and management of this population in clinical practice.Methods:A search strategy was developed,and a computer search of the China Knowledge Network(CNKI),Wanfang Data Medical Information System(WF),China Biomedical Literature Database(CBM),Pubmed,Web of Science(WOS),and Embase databases was applied to retrieve all articles on asymptomatic endometrial polyps and endometrial lesions during menopause since the database was established.Languages were not limited.The data extracted by Rev Man 5.4 software were used for meta-analysis of single rates and risk of bias assessment,and the ratio(OR)and its 95%confidence interval(CI)of the set observed indexes were calculated.Results:A total of 5218 papers were searched in this study,and 46 papers were finally included after screening according to the nadir criteria,including 9 papers in English,1 paper in Portuguese,and the rest in Chinese,involving a total sample size of 40,728 cases.Meta-analysis results:uterine fibroids and adenomyosis(OR=1.98,95%CI:1.64-2.38,P<0.001),previous polyps history(OR=2.50,95%CI:1.79-3.50,P<0.001),hypertension(OR=1.98,95%CI:1.33-2.95,P<0.001),diabetes mellitus(OR=2.06,95%CI:1.44-2.95,P<0.05),obesity(OR=2.66,95%CI:1.70-4.15,P<0.001),chronic endometritis(OR=2.18,95%CI:1.09-4.35,P<0.05),age(OR=1.05,95%CI:1.01-1.09,P<0.001)and menopausal status(OR=3.12,95%CI:1.51-6.42,P<0.001)were high risk factors for the development of endometrial lesions in postmenopausal endometrial polyps,with statistically significant differences,while the application of tamoxifen after breast cancer surgery(OR=0.97,95%CI:0.44-2.13,P>0.05),hormone replacement therapy(OR=3.61,95%CI:2.51-5.19,P>0.05),pregnancy times(OR=1.27,95%CI:0.86-1.87,P<0.001),and number of births(OR=1.01,95%CI:0.81-1.25,P>0.05)were not statistically significant differences and were not high risk factors for malignant postmenopausal asymptomatic endometrial polyps.Conclusions:1.This evidence-based analysis found that some sex hormone-dependent diseases(including adenomyosis,uterine fibroids,and previous history of polyps),metabolic diseases(including hypertension,diabetes,and obesity),chronic endometritis,and increasing age at menopause are high-risk factors for asymptomatic endometrial lesions in postmenopausal women,and hormone replacement therapy,postoperative tamoxifen use for breast cancer,and maternal delivery are not Endometrial polyps are not a high risk factor for endometrial lesions in postmenopausal women.2.If asymptomatic postmenopausal endometrial polyps patients are identified clinically,they should be evaluated comprehensively first.It is recommended that patients with previous endocrine hormone-related diseases,concomitant metabolic syndrome,or chronic endometritis should be given adequate clinical attention,and their relative risk of developing precancerous lesions or malignant EP is higher and should be actively treated clinically.For asymptomatic postmenopausal women with EP without high-risk factors,clinicians may choose to observe follow-up in the light of the specific situation and the patient’s wishes,but patients should be fully informed of the risks of follow-up observation. |
