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Risk of malignancy in endometrial polyps in premenopausal and postmenopausal women according to clinicopathologic characteristics

Costa-Paiva, Lucia MD, PhD; Godoy, Carlos E. Jr MD; Antunes, Armando Jr MD; Caseiro, Joyce D. MD; Arthuso, Michael MD; Pinto-Neto, Aarao M. MD, PhD

doi: 10.1097/gme.0b013e31821e23a1
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Objective The aim of this study was to evaluate the prevalence of endometrial premalignant and malignant polyps in premenopausal and postmenopausal women, as well as the clinical, ultrasound, and hysteroscopic factors associated with malignancy.

Methods All women undergoing hysteroscopic resection of endometrial polyps from January 1998 to December 2008 were selected using a computerized database from the operating theater of the Prof. Dr. José Aristodemo Pinotti Women’s Hospital, Women’s Health Care Center/University of Campinas. Eight hundred seventy women with ages ranging from 25 to 85 years were included. Polyps were classified into benign (endometrial polyps and polyps with nonatypical simple hyperplasia and nonatypical complex hyperplasia), premalignant (polyps with atypical simple hyperplasia or atypical complex hyperplasia), and malignant. Statistical analysis was performed by measurement of the frequencies, means, and SD. The risk factors for malignancy were assessed by bivariate and multiple regression analyses, using the Epi-Info 2000 program and SAS (Statistical Analysis Software), version 9.2.

Results The mean (SD) age of the women was 57.5 (10.6) years. Of these women, 76.4% were postmenopausal. Women were diagnosed with benign lesions in 95.8% of cases. Premalignant polyps accounted for 1.6% of the total number of cases. Malignant polyps represented 2.5% of the total sample. Postmenopausal bleeding and age greater than 60 years were the only factors that remained associated with a higher risk of malignancy with a prevalence ratio of 3.67 (95% CI, 1.69-7.97) and 1.5 (95% CI, 1.01-1.09), respectively.

Conclusions The prevalence rate of malignancy in endometrial polyps was higher in women with postmenopausal bleeding and advanced age.

From the Department of Obstetrics and Gynecology of the University of Campinas Medical School, Campinas, SP, Brazil.

Received February 1, 2011; revised and accepted April 5, 2011.

Funding/support: This work was supported by a public research foundation (financial support for research from Fundação de Amparo a Pesquisa do Estado de São Paulo No. 2009/14629-2).

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Lucia Costa-Paiva, MD, PhD, Department of Obstetrics and Gynecology, Faculty of Medical Sciences, P.O. Box 6111, University of Campinas, 13083-970 Campinas, SP, Brazil. E-mail: paivaepaiva@uol.com.br

©2011The North American Menopause Society