Histopathologic features and risk factors for benignity, hyperplasia, and cancer in endometrial polyps.
OBJECTIVE
The purpose of this study was to determine the rate of benign, hyperplastic, and malignant endometrial polyps and whether clinical data can predict histopathologic outcome.


METHODS
Five hundred nine patients with endometrial polyps who consecutively underwent hysteroscopic removal of endometrial polyps over 48 months were identified from our gynecologic oncology surgical database. Medical reports provided clinical data. Statistical analysis was performed.


RESULTS
Histologically, 358 polyps (70.3%) were benign; 131 polyps (25.7%) had simple or complex endometrial hyperplasia, 16 polyps (3.1%) had hyperplasia with atypia, and 4 polyps (0.8%) were cancerous. Polyps were divided into group A and group B, according to the risk of malignancy (group A, benign; group B, atypical hyperplastic and cancerous). Age, menopause status, and hypertension were associated significantly with group B.


CONCLUSIONS
Endometrial polyps rarely become malignant, but hyperplastic changes are more common. Age, menopause status, and hypertension may increase the risk of premalignant and malignant polyps. To achieve complete removal of the polyp and a reliable histologic analysis, operative hysteroscopy should be offered to symptomatic patients or to patients with risk factors.
Savelli
Luca
L
Department of Obstetrics and Gynecology, University of Bologna, Italy. lucasavelli@rocketmail.com
De Iaco
Pierandrea
P
Santini
Donatella
D
Rosati
Federica
F
Ghi
Tullio
T
Pignotti
Elettra
E
Bovicelli
Luciano
L
D000368:Aged; D000375:Aging / Q000502:physiology; D016889:Endometrial Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D005544:Forecasting; D006801:Humans; D006965:Hyperplasia; D006973:Hypertension / Q000150:complications; D015907:Hysteroscopy; D008593:Menopause; D008875:Middle Aged; D011127:Polyps / Q000150:complications / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors