Influencing Factors for Malignancy in Perimenopausal Women with Endometrial Polyps

Objective To investigate the influencing factors for malignancy in perimenopausal women with endometrial polyps(EP).Methods A total of 884 EP patients identified by histopathology underwent hysteroscopic polypectomy in the Department of Obstetrics and Gynecology,the Combine Traditional Chinese and Western Medicine Hospital of Zhejiang from June 2008 to June 2013 were selected.According to age and menopausal status,the patients were divided into under 40 group(519 cases),menopausal transition group(209 cases) and postmenopausal group(156 cases).Results Malignant transformation was found in 2.26%(20 /884) patients.According to age groups 〔(32.3 ± 15.4) vs.(43.9 ± 7.6) vs.(57.9 ± 10.3) years〕and malignancy rate 〔0.39%(2 /519) vs.4.78%(10 /209) vs.5.13%(8 /156) 〕,there was statistically significant difference(P 0.05).Postmenopausal and menopausal transition were associated with malignant transformation of EP(P 0.05).Multivariate Logistic regression analysis showed that menopausal transition,abnormal uterine bleeding,recurrent EP,and the presence of endometriosis or adenomyosis were associated with EP malignant transformation(P 0.05).Additionally,single factor analysis showed that the malignancy rate of EP in patients in menopausal transition was higher for recurrent EP and EP with abnormal uterine bleeding(P 0.05).Multivariate Logistic regression analysis showed that no factor had a relationship with the menopausal transition in EP malignant transformation(P 0.05).Conclusion Postmenopausal and menopausal transition status are associated with an increased risk of Epmalignant transformation.Menopausal transition,recurrent EP,polyps greater than 10 mm in size,abnormal uterine bleeding,and combination with endometriosis or adenomyosis are associated with a higher risk for malignant lesions.