Usefulness of Clinical, Ultrasonographic, Hysteroscopic, and Immunohistochemical Parameters in Differentiating Endometrial Polyps From Endometrial Cancer

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Data

2014-03-01

Autores

Dias, Daniel Spadoto [UNESP]
Bueloni-Dias, Flavia Neves [UNESP]
Dias, Rogerio [UNESP]
Nahas-Neto, Jorge [UNESP]
Nahás, Eliana Aguiar Petri [UNESP]
Leite, Nilton Jose [UNESP]
Domingues, Maria Aparecida Custódio [UNESP]
Bueno Angela, Solange Peron [UNESP]
Padovani, Carlos Roberto [UNESP]

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Editor

Elsevier B.V.

Resumo

Study Objective: To evaluate the usefulness of clinical, ultrasonographic, hysteroscopic, and immunohistochemical parameters in differentiating endometrial polyps from endometrial cancer.Design: Cross-sectional study (Canadian Task Force classification II-2).Setting: Tertiary public hospital, university teaching center.Patients: Eighty-two women who underwent hysteroscopic polypectomy and 20 women who underwent surgery to treat endometrial cancer.Interventions: Analysis of medical records and immunohistochemical assessment of estrogen receptors, progesterone receptors, and endothelial markers CD34 and CD 105.Measurements and Main Results: Among women with endometrial cancer and endometrial polyps, respectively, mean age was 63 and 57 years (p = .01), 89% and 67% were postmenopausal (p < .05), and 85% and 30.5% had postmenopausal bleeding (p < .01). No sonographic parameter enabled differentiation of endometrial polyp from cancer. Of patients with endometrial cancer, 72% exhibited signs suggestive of hyperplasia, and endometrial polyps were diagnosed during hysteroscopy. Estrogen receptors (>= 2 vs >= 1; p < .001) and progesterone receptors (>= 3 vs >= 2; p = .07) were greater in endometrial polyps. There was no significant difference in microvessel density (p > .05).Conclusions: Ultrasonographic parameters and endothelial markers did not enable differentiation of polyps from endometrial neoplasia. Postmenopausal bleeding and endometrial hypervascularization along with vascular atypia at diagnostic hysteroscopy showed a greater association with endometrial cancer. (c) 2014 AAGL. All rights reserved.

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Palavras-chave

Endoglin protein (CD105 antigen), Endometrial neoplasms/anatomy and histology/diagnosis, Immunohistochemistry, Microvessels/analysis, Polyps/anatomy and histology/diagnosis

Como citar

Journal Of Minimally Invasive Gynecology. New York: Elsevier Science Inc, v. 21, n. 2, p. 296-302, 2014.