Suspecting malignancy in endometrial polyps: Value of hysteroscopy

Alberto Daniele, Annamaria Ferrero, Furio Maggiorotto, Gaetano Perrini, Eugenio Volpi, Piero Sismondi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims and background. Hysteroscopic polypectomy is the gold standard to treat endometrial polyps and obtain specimens for histological evaluation. There is continuing debate as to when to offer hysteroscopic polypectomy, especially in asymptomatic women with incidental lesions. The aims of this study were to assess the accuracy of hysteroscopy and Vabra sampling in diagnosing atypical hyperplasia and cancer growing on the surface of endometrial polyps and to investigate the association between atypical endometrial polyps and some potential clinical risk factors. Methods and study design. This was a retrospective study.We assessed 1039 hysteroscopies and we identified 345 women with endometrial polyps. All patients with endometrial polyps underwent hysteroscopic polypectomy. Data about age, menopausal status, abnormal uterine bleeding (AUB), hormone replacement therapy and tamoxifen use were collected. Hysteroscopic, histological and clinical data were analyzed. Results. The incidence of endometrial hyperplasia or cancer growing on the surface of endometrial polyps was significantly low (1.7%). Hysteroscopy correctly excluded (negative predictive value: 100%) and accurately predicted (positive predictive value: 85.7%) preneoplastic or neoplastic lesions growing within the epithelial layer of endometrial polyps. Vabra sampling was inadequate for the histological diagnosis in 38.5% of cases. Age over 60 years and postmenopausal AUB were associated with an 8.3-fold (P = 0.022) and 8.8-fold (P = 0.020) increased risk, respectively, of preneoplastic and neoplastic lesions growing on the surface of endometrial polyps. Conclusions. Diagnostic hysteroscopy is a good tool to predict malignancy of the epithelial layer of endometrial polyps. Age over 60 years and AUB are associated with an increased risk of malignant polyps. Few suspicious endometrial polyps should undergo surgical resection.

Original languageEnglish
Pages (from-to)204-209
Number of pages6
JournalTumori
Volume99
Issue number2
DOIs
Publication statusPublished - Mar 2013

Fingerprint

Hysteroscopy
Polyps
Neoplasms
Uterine Hemorrhage
Endometrial Hyperplasia
Hormone Replacement Therapy
Tamoxifen
Endometrial Neoplasms
Hyperplasia
Retrospective Studies

Keywords

  • Endometrial cancer
  • Endometrial polyps
  • Hysteroscopy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Daniele, A., Ferrero, A., Maggiorotto, F., Perrini, G., Volpi, E., & Sismondi, P. (2013). Suspecting malignancy in endometrial polyps: Value of hysteroscopy. Tumori, 99(2), 204-209. https://doi.org/10.1700/1283.14193

Suspecting malignancy in endometrial polyps : Value of hysteroscopy. / Daniele, Alberto; Ferrero, Annamaria; Maggiorotto, Furio; Perrini, Gaetano; Volpi, Eugenio; Sismondi, Piero.

In: Tumori, Vol. 99, No. 2, 03.2013, p. 204-209.

Research output: Contribution to journalArticle

Daniele, A, Ferrero, A, Maggiorotto, F, Perrini, G, Volpi, E & Sismondi, P 2013, 'Suspecting malignancy in endometrial polyps: Value of hysteroscopy', Tumori, vol. 99, no. 2, pp. 204-209. https://doi.org/10.1700/1283.14193
Daniele A, Ferrero A, Maggiorotto F, Perrini G, Volpi E, Sismondi P. Suspecting malignancy in endometrial polyps: Value of hysteroscopy. Tumori. 2013 Mar;99(2):204-209. https://doi.org/10.1700/1283.14193
Daniele, Alberto ; Ferrero, Annamaria ; Maggiorotto, Furio ; Perrini, Gaetano ; Volpi, Eugenio ; Sismondi, Piero. / Suspecting malignancy in endometrial polyps : Value of hysteroscopy. In: Tumori. 2013 ; Vol. 99, No. 2. pp. 204-209.
@article{b9adfa2405b240639def289764ab60f8,
title = "Suspecting malignancy in endometrial polyps: Value of hysteroscopy",
abstract = "Aims and background. Hysteroscopic polypectomy is the gold standard to treat endometrial polyps and obtain specimens for histological evaluation. There is continuing debate as to when to offer hysteroscopic polypectomy, especially in asymptomatic women with incidental lesions. The aims of this study were to assess the accuracy of hysteroscopy and Vabra sampling in diagnosing atypical hyperplasia and cancer growing on the surface of endometrial polyps and to investigate the association between atypical endometrial polyps and some potential clinical risk factors. Methods and study design. This was a retrospective study.We assessed 1039 hysteroscopies and we identified 345 women with endometrial polyps. All patients with endometrial polyps underwent hysteroscopic polypectomy. Data about age, menopausal status, abnormal uterine bleeding (AUB), hormone replacement therapy and tamoxifen use were collected. Hysteroscopic, histological and clinical data were analyzed. Results. The incidence of endometrial hyperplasia or cancer growing on the surface of endometrial polyps was significantly low (1.7{\%}). Hysteroscopy correctly excluded (negative predictive value: 100{\%}) and accurately predicted (positive predictive value: 85.7{\%}) preneoplastic or neoplastic lesions growing within the epithelial layer of endometrial polyps. Vabra sampling was inadequate for the histological diagnosis in 38.5{\%} of cases. Age over 60 years and postmenopausal AUB were associated with an 8.3-fold (P = 0.022) and 8.8-fold (P = 0.020) increased risk, respectively, of preneoplastic and neoplastic lesions growing on the surface of endometrial polyps. Conclusions. Diagnostic hysteroscopy is a good tool to predict malignancy of the epithelial layer of endometrial polyps. Age over 60 years and AUB are associated with an increased risk of malignant polyps. Few suspicious endometrial polyps should undergo surgical resection.",
keywords = "Endometrial cancer, Endometrial polyps, Hysteroscopy",
author = "Alberto Daniele and Annamaria Ferrero and Furio Maggiorotto and Gaetano Perrini and Eugenio Volpi and Piero Sismondi",
year = "2013",
month = "3",
doi = "10.1700/1283.14193",
language = "English",
volume = "99",
pages = "204--209",
journal = "Tumori",
issn = "0300-8916",
publisher = "SAGE Publications Ltd",
number = "2",

}

TY - JOUR

T1 - Suspecting malignancy in endometrial polyps

T2 - Value of hysteroscopy

AU - Daniele, Alberto

AU - Ferrero, Annamaria

AU - Maggiorotto, Furio

AU - Perrini, Gaetano

AU - Volpi, Eugenio

AU - Sismondi, Piero

PY - 2013/3

Y1 - 2013/3

N2 - Aims and background. Hysteroscopic polypectomy is the gold standard to treat endometrial polyps and obtain specimens for histological evaluation. There is continuing debate as to when to offer hysteroscopic polypectomy, especially in asymptomatic women with incidental lesions. The aims of this study were to assess the accuracy of hysteroscopy and Vabra sampling in diagnosing atypical hyperplasia and cancer growing on the surface of endometrial polyps and to investigate the association between atypical endometrial polyps and some potential clinical risk factors. Methods and study design. This was a retrospective study.We assessed 1039 hysteroscopies and we identified 345 women with endometrial polyps. All patients with endometrial polyps underwent hysteroscopic polypectomy. Data about age, menopausal status, abnormal uterine bleeding (AUB), hormone replacement therapy and tamoxifen use were collected. Hysteroscopic, histological and clinical data were analyzed. Results. The incidence of endometrial hyperplasia or cancer growing on the surface of endometrial polyps was significantly low (1.7%). Hysteroscopy correctly excluded (negative predictive value: 100%) and accurately predicted (positive predictive value: 85.7%) preneoplastic or neoplastic lesions growing within the epithelial layer of endometrial polyps. Vabra sampling was inadequate for the histological diagnosis in 38.5% of cases. Age over 60 years and postmenopausal AUB were associated with an 8.3-fold (P = 0.022) and 8.8-fold (P = 0.020) increased risk, respectively, of preneoplastic and neoplastic lesions growing on the surface of endometrial polyps. Conclusions. Diagnostic hysteroscopy is a good tool to predict malignancy of the epithelial layer of endometrial polyps. Age over 60 years and AUB are associated with an increased risk of malignant polyps. Few suspicious endometrial polyps should undergo surgical resection.

AB - Aims and background. Hysteroscopic polypectomy is the gold standard to treat endometrial polyps and obtain specimens for histological evaluation. There is continuing debate as to when to offer hysteroscopic polypectomy, especially in asymptomatic women with incidental lesions. The aims of this study were to assess the accuracy of hysteroscopy and Vabra sampling in diagnosing atypical hyperplasia and cancer growing on the surface of endometrial polyps and to investigate the association between atypical endometrial polyps and some potential clinical risk factors. Methods and study design. This was a retrospective study.We assessed 1039 hysteroscopies and we identified 345 women with endometrial polyps. All patients with endometrial polyps underwent hysteroscopic polypectomy. Data about age, menopausal status, abnormal uterine bleeding (AUB), hormone replacement therapy and tamoxifen use were collected. Hysteroscopic, histological and clinical data were analyzed. Results. The incidence of endometrial hyperplasia or cancer growing on the surface of endometrial polyps was significantly low (1.7%). Hysteroscopy correctly excluded (negative predictive value: 100%) and accurately predicted (positive predictive value: 85.7%) preneoplastic or neoplastic lesions growing within the epithelial layer of endometrial polyps. Vabra sampling was inadequate for the histological diagnosis in 38.5% of cases. Age over 60 years and postmenopausal AUB were associated with an 8.3-fold (P = 0.022) and 8.8-fold (P = 0.020) increased risk, respectively, of preneoplastic and neoplastic lesions growing on the surface of endometrial polyps. Conclusions. Diagnostic hysteroscopy is a good tool to predict malignancy of the epithelial layer of endometrial polyps. Age over 60 years and AUB are associated with an increased risk of malignant polyps. Few suspicious endometrial polyps should undergo surgical resection.

KW - Endometrial cancer

KW - Endometrial polyps

KW - Hysteroscopy

UR - http://www.scopus.com/inward/record.url?scp=84881237545&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881237545&partnerID=8YFLogxK

U2 - 10.1700/1283.14193

DO - 10.1700/1283.14193

M3 - Article

C2 - 23748815

AN - SCOPUS:84881237545

VL - 99

SP - 204

EP - 209

JO - Tumori

JF - Tumori

SN - 0300-8916

IS - 2

ER -