Prevalencia de carcinoma en pólipos endometriales resecados por histeroscopia.
Prevalence of cancer in endometrial polypsIn patients undergoing hysteroscopic polypectomy
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Polo, J. F., Puentes, L. O., Falla, N. F., Mendoza, J., & Parra Medina, R. (2019). Prevalencia de carcinoma en pólipos endometriales resecados por histeroscopia. Revista Repertorio De Medicina Y Cirugía, 28(2). https://doi.org/10.31260/RepertMedCir.v28.n2.2019.919
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La prevalencia de pólipos endometriales (PE) es alrededor de 24% en la población femenina general y entre 10 y 30% en aquellas con hemorragia uterina anormal. Son lesiones de crecimiento rápido que pueden transformarse en una neoplasia maligna. Objetivo: determinar la frecuencia de cáncer endometrial en pacientes con PE diagnosticados por histeroscopia. Metodología: serie de casos retrospectivos atendidos en el Hospital de San José, Bogotá, Colombia, de 2005 a 2014. Resultados: se analizaron en total 408 historias clínicas de pacientes con diagnóstico histopatológico de PE, 10 (2.4%) presentaron patología premaligna y 9 (2,2%) lesión maligna confirmada por microscopía (endometrioides 6, seroso papilar 2 y carcinosarcoma 1). Todas las pacientes con patología maligna tenían más de 60 años y estaban en posmenopausia. Cuatro eran nulíparas, ninguna consumía tamoxifeno ni medicamentos hormonales Conclusión: la prevalencia de carcinomas endometriales en PE diagnosticados a través de histeroscopia en mujeres posmenopáusicas fue de 7.7%. Estos datos son similares a los reportados en la literatura, por lo que recomendamos la implementación de histeroscopia para el tratamiento de todos los PE y su riguroso estudio histopatológico.
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1. Antunes A, Jr., Costa-Paiva L, Arthuso M, Costa JV, Pinto-Neto AM. Endometrial polyps in pre- and postmenopausal women: factors associated with malignancy. Maturitas. 2007;57(4):415-21.
2. Ricciardi E, Vecchione A, Marci R, Schimberni M, Frega A, Maniglio P, et al. Clinical factors and malignancy in endometrial polyps. Analysis of 1027 cases. Eur J Obstet Gynecol Reprod Biol. 2014;183:121-4.
3. Hileeto D, Fadare O, Martel M, Zheng W. Age dependent association of endometrial polyps with increased risk of cancer involvement. World J Surg Oncol. 2005;3(1):8.
4. Anastasiadis PG, Koutlaki NG, Skaphida PG, Galazios GC, Tsikouras PN, Liberis VA. Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding. Eur J Gynaecol Oncol. 2000;21(2):180-3.
5. Goldstein SR, Monteagudo A, Popiolek D, Mayberry P, Timor-Tritsch I. Evaluation of endometrial polyps. Am J Obstet Gynecol. 2002;186(4):669-74.
6. Savelli L, De Iaco P, Santini D, Rosati F, Ghi T, Pignotti E, et al. Histopathologic features and risk factors for benignity, hyperplasia, and cancer in endometrial polyps. Am J Obstet Gynecol. 2003;188(4):927-31.
7. Orvieto R, Bar-Hava I, Dicker D, Bar J, Ben-Rafael Z, Neri A. Endometrial polyps during menopause: characterization and significance. Acta Obstet Gynecol Scand. 1999;78(10):883-6.
8. de Vries LD, Dijkhuizen FP, Mol BW, Brolmann HA, Moret E, Heintz AP. Comparison of transvaginal sonography, saline infusion sonography, and hysteroscopy in premenopausal women with abnormal uterine bleeding. J Clin Ultrasound. 2000;28(5):217-23.
9. Muzaffar M, Akhtar KA, Yasmin S, Mahmood Ur R, Iqbal W, Khan MA. Menstrual irregularities with excessive blood loss: a clinico-pathological correlation. J Pak Med Assoc. 2005;55(11):486-9.
10. Sant'Ana de Almeida EC, Nogueira AA, Candido dos Reis FJ, Zambelli Ramalho LN, Zucoloto S. Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps and adjacent endometrium in postmenopausal women. Maturitas. 2004;49(3):229-33.
11. Fernandez-Parra J, Rodriguez Oliver A, Lopez Criado S, Parrilla Fernandez F, Montoya Ventoso F. Hysteroscopic evaluation of endometrial polyps. Int J Gynaecol Obstet. 2006;95(2):144-8. Epub 2006/08/22.
12. Ben-Arie A, Goldchmit C, Laviv Y, Levy R, Caspi B, Huszar M, et al. The malignant potential of endometrial polyps. Eur J Obstet Gynecol Reprod Biol. 2004;115(2):206-10.
13. Shushan A, Revel A, Rojansky N. How often are endometrial polyps malignant? Gynecol Obstet Invest. 2004;58(4):212-5.
14. Oguz S, Sargin A, Kelekci S, Aytan H, Tapisiz OL, Mollamahmutoglu L. The role of hormone replacement therapy in endometrial polyp formation. Maturitas. 2005;50(3):231-6.
15. Bakour SH, Khan KS, Gupta JK. The risk of premalignant and malignant pathology in endometrial polyps. Acta Obstet Gynecol Scand. 2000;79(4):317-20.
16. Lee SC, Kaunitz AM, Sanchez-Ramos L, Rhatigan RM. The oncogenic potential of endometrial polyps: a systematic review and meta-analysis. Obstet Gynecol. 2010;116(5):1197-205.
17. Dreisler E, Stampe Sorensen S, Ibsen PH, Lose G. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years. Ultrasound Obstet Gynecol. 2009;33(1):102-8.
18. Ferrazzi E, Zupi E, Leone FP, Savelli L, Omodei U, Moscarini M, et al. How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study. Am J Obstet Gynecol. 2009;200(3):235.e1-6.
19. Lindemann K, Vatten LJ, Ellstrom-Engh M, Eskild A. Body mass, diabetes and smoking, and endometrial cancer risk: a follow-up study. Br J Cancer. 2008;98(9):1582-5.
20. Folsom AR, Kaye SA, Potter JD, Prineas RJ. Association of incident carcinoma of the endometrium with body weight and fat distribution in older women: early findings of the Iowa Women's Health Study. Cancer Res. 1989;49(23):6828-31.
21. Wang JH, Zhao J, Lin J. Opportunities and risk factors for premalignant and malignant transformation of endometrial polyps: management strategies. J Minim Invasive Gynecol. 2010;17(1):53-8.
22. Gregoriou O, Konidaris S, Vrachnis N, Bakalianou K, Salakos N, Papadias K, et al. Clinical parameters linked with malignancy in endometrial polyps. Climacteric. 2009;12(5):454-8.
23. Lieng M, Qvigstad E, Sandvik L, Jorgensen H, Langebrekke A, Istre O. Hysteroscopic resection of symptomatic and asymptomatic endometrial polyps. J Minim Invasive Gynecol. 2007;14(2):189-94. Epub 2007/03/21.
24. McGurgan P, Taylor LJ, Duffy SR, O'Donovan PJ. An immunohistochemical comparison of endometrial polyps from postmenopausal women exposed and not exposed to HRT. Maturitas. 2006;53(4):454-61.
25. Bergman L, Beelen ML, Gallee MP, Hollema H, Benraadt J, van Leeuwen FE. Risk and prognosis of endometrial cancer after tamoxifen for breast cancer. Comprehensive Cancer Centres' ALERT Group. Assessment of Liver and Endometrial cancer Risk following Tamoxifen. Lancet. 2000;356(9233):881-7.
26. Garuti G, Sambruni I, Colonnelli M, Luerti M. Accuracy of hysteroscopy in predicting histopathology of endometrium in 1500 women. J Am Assoc Gynecol Laparosc. 2001;8(2):207-13.
27. Machtinger R, Korach J, Padoa A, Fridman E, Zolti M, Segal J, et al. Transvaginal ultrasound and diagnostic hysteroscopy as a predictor of endometrial polyps: risk factors for premalignancy and malignancy. Int J Gynecol Cancer. 2005;15(2):325-8.
2. Ricciardi E, Vecchione A, Marci R, Schimberni M, Frega A, Maniglio P, et al. Clinical factors and malignancy in endometrial polyps. Analysis of 1027 cases. Eur J Obstet Gynecol Reprod Biol. 2014;183:121-4.
3. Hileeto D, Fadare O, Martel M, Zheng W. Age dependent association of endometrial polyps with increased risk of cancer involvement. World J Surg Oncol. 2005;3(1):8.
4. Anastasiadis PG, Koutlaki NG, Skaphida PG, Galazios GC, Tsikouras PN, Liberis VA. Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding. Eur J Gynaecol Oncol. 2000;21(2):180-3.
5. Goldstein SR, Monteagudo A, Popiolek D, Mayberry P, Timor-Tritsch I. Evaluation of endometrial polyps. Am J Obstet Gynecol. 2002;186(4):669-74.
6. Savelli L, De Iaco P, Santini D, Rosati F, Ghi T, Pignotti E, et al. Histopathologic features and risk factors for benignity, hyperplasia, and cancer in endometrial polyps. Am J Obstet Gynecol. 2003;188(4):927-31.
7. Orvieto R, Bar-Hava I, Dicker D, Bar J, Ben-Rafael Z, Neri A. Endometrial polyps during menopause: characterization and significance. Acta Obstet Gynecol Scand. 1999;78(10):883-6.
8. de Vries LD, Dijkhuizen FP, Mol BW, Brolmann HA, Moret E, Heintz AP. Comparison of transvaginal sonography, saline infusion sonography, and hysteroscopy in premenopausal women with abnormal uterine bleeding. J Clin Ultrasound. 2000;28(5):217-23.
9. Muzaffar M, Akhtar KA, Yasmin S, Mahmood Ur R, Iqbal W, Khan MA. Menstrual irregularities with excessive blood loss: a clinico-pathological correlation. J Pak Med Assoc. 2005;55(11):486-9.
10. Sant'Ana de Almeida EC, Nogueira AA, Candido dos Reis FJ, Zambelli Ramalho LN, Zucoloto S. Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps and adjacent endometrium in postmenopausal women. Maturitas. 2004;49(3):229-33.
11. Fernandez-Parra J, Rodriguez Oliver A, Lopez Criado S, Parrilla Fernandez F, Montoya Ventoso F. Hysteroscopic evaluation of endometrial polyps. Int J Gynaecol Obstet. 2006;95(2):144-8. Epub 2006/08/22.
12. Ben-Arie A, Goldchmit C, Laviv Y, Levy R, Caspi B, Huszar M, et al. The malignant potential of endometrial polyps. Eur J Obstet Gynecol Reprod Biol. 2004;115(2):206-10.
13. Shushan A, Revel A, Rojansky N. How often are endometrial polyps malignant? Gynecol Obstet Invest. 2004;58(4):212-5.
14. Oguz S, Sargin A, Kelekci S, Aytan H, Tapisiz OL, Mollamahmutoglu L. The role of hormone replacement therapy in endometrial polyp formation. Maturitas. 2005;50(3):231-6.
15. Bakour SH, Khan KS, Gupta JK. The risk of premalignant and malignant pathology in endometrial polyps. Acta Obstet Gynecol Scand. 2000;79(4):317-20.
16. Lee SC, Kaunitz AM, Sanchez-Ramos L, Rhatigan RM. The oncogenic potential of endometrial polyps: a systematic review and meta-analysis. Obstet Gynecol. 2010;116(5):1197-205.
17. Dreisler E, Stampe Sorensen S, Ibsen PH, Lose G. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years. Ultrasound Obstet Gynecol. 2009;33(1):102-8.
18. Ferrazzi E, Zupi E, Leone FP, Savelli L, Omodei U, Moscarini M, et al. How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study. Am J Obstet Gynecol. 2009;200(3):235.e1-6.
19. Lindemann K, Vatten LJ, Ellstrom-Engh M, Eskild A. Body mass, diabetes and smoking, and endometrial cancer risk: a follow-up study. Br J Cancer. 2008;98(9):1582-5.
20. Folsom AR, Kaye SA, Potter JD, Prineas RJ. Association of incident carcinoma of the endometrium with body weight and fat distribution in older women: early findings of the Iowa Women's Health Study. Cancer Res. 1989;49(23):6828-31.
21. Wang JH, Zhao J, Lin J. Opportunities and risk factors for premalignant and malignant transformation of endometrial polyps: management strategies. J Minim Invasive Gynecol. 2010;17(1):53-8.
22. Gregoriou O, Konidaris S, Vrachnis N, Bakalianou K, Salakos N, Papadias K, et al. Clinical parameters linked with malignancy in endometrial polyps. Climacteric. 2009;12(5):454-8.
23. Lieng M, Qvigstad E, Sandvik L, Jorgensen H, Langebrekke A, Istre O. Hysteroscopic resection of symptomatic and asymptomatic endometrial polyps. J Minim Invasive Gynecol. 2007;14(2):189-94. Epub 2007/03/21.
24. McGurgan P, Taylor LJ, Duffy SR, O'Donovan PJ. An immunohistochemical comparison of endometrial polyps from postmenopausal women exposed and not exposed to HRT. Maturitas. 2006;53(4):454-61.
25. Bergman L, Beelen ML, Gallee MP, Hollema H, Benraadt J, van Leeuwen FE. Risk and prognosis of endometrial cancer after tamoxifen for breast cancer. Comprehensive Cancer Centres' ALERT Group. Assessment of Liver and Endometrial cancer Risk following Tamoxifen. Lancet. 2000;356(9233):881-7.
26. Garuti G, Sambruni I, Colonnelli M, Luerti M. Accuracy of hysteroscopy in predicting histopathology of endometrium in 1500 women. J Am Assoc Gynecol Laparosc. 2001;8(2):207-13.
27. Machtinger R, Korach J, Padoa A, Fridman E, Zolti M, Segal J, et al. Transvaginal ultrasound and diagnostic hysteroscopy as a predictor of endometrial polyps: risk factors for premalignancy and malignancy. Int J Gynecol Cancer. 2005;15(2):325-8.
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