Author/Editor     Verdenik-Golob, Branka
Title     Klinične in histološke značilnosti endometrijskih polipov
Translated title     Clinic and histologic characteristics of endometrial polyps
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 75, št. 12
Publication year     2006
Volume     str. 823-7
Language     slo
Abstract     Background The prevalence of endometrial polyps (EP) is high (25%), but the risk of malignancy low. Women are often asymptomatic. More EP are being diagnosed with the use of transvaginal ultrasound scanning. The purpose of this study was to estimate the incidence of symptomatic and asymptomatic EP and determine whether clinical risk factors and symptoms can predict its histopathological characteristics. Methods Retrospective study of 271 women with removed EP in the years 2001-2006 was done. 53.1% patients underwent operative histeroscopy, 46.9% uterine curettage. Clinical data were obtained from patients' medical reports. PS were subdivided groups as symptomatic A and asymptomatic B; benign (hyperplastic without atypia, cancerous). Statistical analysis was performed. Results In 185 patients (68.3%) EP were symptomatic, in 86 (31.7%) asymptomatic. In group A 2 hyperplastic EP without atypia (0.74%), one hyperplastic EP with atypia (0.37%) and one cancerous EP (0.37%) were found. In group B all were benign. Patient age, menopusal status (p < 0.01, negative correlation) and hypertension (p < 0.05, negative correltion) were associated with symptoms significantly. Hypertension showed a significant association with malignant EP (p < 0.05). Conclusions The incidence of malignancy is low. Symptoms were correlated with age, in postmenopausal women more likely asymptomatic and characteristically related to hypertension which is an important risk factor with malignant degeneration of EP. Asymptomatic EP were all benign but not significantly. Hystopathology remains the gold standard. Its removal (hysteroscopic) would be a suitable rationale, especially in hypertensive women.
Summary     Izhodišča Endometrijski polipi (EP) se pojavljajo pri približno 25% žensk. Incidenca malignosti je nizka. Pogosto so asimptomatski, s široko uporabo transvaginalne ultrazvočne preiskave jih vse pogosteje odkrivamo. Namen raziskave je bil oceniti incidenco simptomatskih in asimptomatskih EP ter ugotoviti, ali klinični dejavniki tveganja in pojav simptomov napovedujejo histološke značilnosti. Metode V retrospektivno raziskavo smo vključili 272 žensk, pri katerih je bil v letih 2001-2006 odstranjen EP. Pri 53,1% bolnic je bila opravljena histeroskopska operacija, pri 469 bolnic pa kiretaža. Klinične podatke smo pridobili iz popisov bolezni. Glede na prisotnost nepravilne maternične krvavitve in histološki izvid smo EP razvrstili v dve skupini, simptomatsko A in asimptomatsko B ter na benigne (benigni, hiperplastični brez atipij) in maligne (hiperplastični z atipijami, rakasti). Podatke smo statistično ovrednotili. Rezultati Pri 185 ženskah (68,3%) so bili EP simptomatski, pri 86 (31,7%) asimptomatski. Vskupini A smo našli 2 hiperplastičrca EP brez atipij (0,74%), EP z endometrijsko hiperplazijo z zmernimi atipijami (0,37%) ter EP z adenokarcinomom (0,37%). Vskupini B so bili vsi benigni. S pojavom simptomov so bili statistično značilno povezani starost (p < 0,01, korelacija pozitivna), menopavzni status (p < 0,01, korelacija negativna) in hipertenzija (p < 0,05, korelacija negativna), s histološkim izvidom le hipertenzija (p < 0,05). Zaključki Incidenca malignih EP je nizka. Pojav simptomov narašča s starostjo. V pomenopavzi pogosteje ne povzročajo simptomov, so pa značilno povezani s hipertenzijo, ki je pomemben dejavnik tveganja za maligno degeneracijo EP. Asimptomatski EP so bili vsi benigni, vendar statistično neznačilno. Histopatološka preiskava ostaja najzanesljivejša metoda v razlikovanju med benignimi in malignimi EP, zato jih je priporočljivo odstraniti, zlasti pri ženskah s hipertenzijo. Metoda izbire je histeroskopska operacija.
Descriptors     ENDOMETRIAL NEOPLASMS
POLYPS
UTERINE HEMORRHAGE
HYSTEROSCOPY
RISK FACTORS