Murat EKİN, Hüseyin CENGİZ, Şükrü YILDIZ, Cihan KAYA, Hediye DAĞDEVİREN, Keziban DOĞAN

Premalignant and malignant changes in endometrial polyps

Bu çalışmada operatif histeroskopi ile çıkarılan endometrial poliplerde, premalign ve malign değişikliklerin prevelansını ve riskini değerlendirmek amaçlandı. Çalışma grubuna, Ocak 2010-Temmuz 2012 arasında Kadın Hastalıkları ve Doğum Kliniğine diagnostik histeroskopi, transvajinal ultrasonografi ve salin infüzyon sonohisterografi ile tanı konulan 101 endometrial polip olgusu dahil edildi. Medikal kayıtlar retrospektif olarak incelendi. Operatif işlemler genel anestezi altında yapıldı. Operasyon spesimenleri histolojik inceleme için %10luk formaldehid içerisine konuldu. Medikal kayıtlardan; yaş, parite, menopozal durum, hipertansiyon (diastolik basınç ≥90 mmHg ve/veya sistolik basınç ≥140 mmHg olarak tanımlanmıştır), anormal uterin kanama, diabet (açlık şekeri ≥110 mg/dl) gibi klinik karekteristik özellikler incelendi. İstatistiksel analiz SPSS 11.5 istatistik paket programı (SPSS, Chicago, IL, ABD) kullanılarak yapıldı. Çalışma grubunun ortalama yaşı 45 (25-73) idi. Operatif histeroskopi için en sık endikasyon anormal uterin kanama olarak saptandı %82.2 (n=83). Üç hastada (%2.9) poliplerde premalign ve malign değişiklikler tespit edildi. Elli sekiz yaşındaki bir hastada invaziv endometrial kanser tespit edildi. Klinik özelliklerin (diabetes mellitus, hipertansiyon, hormon replasman tedavisi) hiçbiri histopatolojik sonuçlarla istatistiksel olarak ilişkili bulunmadı. Endometrial poliplerde premalign ve malign değişikliklerin prevelansı düşük olmasına rağmen malignite ihtimali her zaman göz önünde bulundurulmalıdır. Operatif histereskopi uygulamasının en sık endikasyonu anormal uterin kanamadır.

Endometrial poliplerde premalign ve malign değişiklikler

The objective of this study was to evaluate the risk of premalignant and malignant changes in endometrial polyps that were removed entirely by operative hysteroscopy. The study group was comprised of 101 cases of endometrial polyps diagnosed by diagnostic hysteroscopy, transvaginal ultrasonography and saline contrast sonohysterography in our Obstetrics and Gynecology Clinic from January 2010 to July 2012. A retrospective chart review was then performed with the use of medical records. The operative procedure was performed under general anesthesia. The specimens were placed in 10% formaldehyde for histological examination. Clinical characteristics such as age, parity, menopausal status, hypertension (defined as diastolic pressure ≥90 mm Hg and/or systolic pressure ≥140 mm Hg), abnormal uterine bleeding, diabetes (fasting glucose ≥110 mg/dl) were also reported from the medical records. Statistical Analysis was performed by using the SPSS 11.5 statistical software package (SPSS, Chicago, IL, USA). The mean age of the study group was 45 (25-73) years-old. The most common indication for performing operative hysteroscopy was abnormal uterine bleeding 82.2% (n=83). It is worthwhile to note that 3 patients (2.9%) had premalignant and malignant changes of polyps. One patient who was 58 years old had invasive endometrial cancer. None of the clinical variables considered (diabetes mellitus, hypertension, hormone replacement therapy) were statistically related to the histopathological results. Although the prevalence of premalignant and malignant endometrial polyps is very low, the early diagnosis of malignancy is very important. The most common indication was abnormal uterin bleeding for performing operative hysterescopy.

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