Avaliação da malignidade de pólipos endometriais na pós-menopausa.

Abstract

Endometrial polyps are focal endometrial growths that form circumscribed masses. In general population it has a prevalence between 20 to 30%. As for his malignant, present in up to 12.9% in postmenopausal, we find from hyperplastic lesions to endometrial carcinoma. Risk factors reported for malignancy are age, nulliparity, early menarche, late menopause, large polyps, use of Tamoxifen and hormone replacement therapy (HRT), Metabolic Syndrome and the presence of dysfunctional uterine bleeding (DUB). We emphasize the importance of studying this subject, because despite the higher prevalence in postmenopausal women being associated with increased malignant rate, the management forward polyps in this age is still controversial. The research objectives are to evaluate the malignancy rate of endometrial polyps in women after menopause, and describe, according to the histopathology, the patient's age, age of menopause, post-menopause time, race, parity, presence of diabetes and / or hypertension, symptoms (as DUB), and use of Tamoxifen or HRT. This is an epidemiological, descriptive and cross-sectional study, in which we studied the postmenopausal patients undergoing hysteroscopy in 2015, with a diagnosis of endometrial polyp at an University Hospital in Campina Grande-PB. The final sample consisted of 49 patients, 4 of them with adenocarcinoma. In the results, dividing into groups with benign and malignant histopathology, we find, respectively, the mean age of 60.91 x 58.75 years, menopause age of 58.68 x 48.5 years, time since menopause of 10 26 x 10.25 years, parity of 3.48 x 1 children, diabetes prevalence of 22 x 0% and hypertension of 57.77 x 25%, uterine bleeding in 11.11% x 25% and Caucasians as 55 , 5 x 75%. HRT and Tamoxifen were reported in one patient each, both with benign polyps. We note that the variables of patient age, age of manopausa , time since menopause , diabetes and hipertesão did not agree with reports in the literature that highlight them as risk factors. However, the lower parity, white race and presence of uterine bleeding were actually higher in the group with cancer, as expected according to the literature in general. More recent analytical studies have questioned these traditional risk factors , and noted that the presence of DUB is the most reliable and significant variable. New researches are necessary with a bigger number of patients, in order to validate the perceptions and approaches on risk factors to this patology, contributing to reduce gaps between the theory and daily approach