子宫内膜息肉潜在恶变的Meta分析

The Malignant Potential of Endometrial Polyps:A Meta-Analysis

目的对子宫内膜息肉患者的绝经状况及子宫出血状况对内膜息肉潜在恶变或恶变的影响进行Meta分析。方法计算机检索Cochrane图书馆、Pubmed、EMBASE、维普和CNKI数据库等,纳入所有关于子宫内膜息肉恶变风险的文章。根据异质性检验结果,采用随机效应模型计算相对危险度(RR)以及其95%CI。结果 19篇文章符合纳入标准,共12431名患者,其中428位患者的内膜息肉为恶性,恶性率为3.44%。通过随机效应模型分析,子宫出血状况作为内膜息肉恶变的风险因素有统计学意义(Z=3.72,P<0.05),RR=2.14,其95%CI为1.43～3.20;同样,绝经状况作为内膜息肉恶变的风险因素也有统计学意义(Z=7.64,P<0.01),RR=4.25,其95%CI为2.93～6.17。结论本研究认为子宫异常出血和绝经状况是影响子宫内膜息肉恶变的独立风险因素。

Objective To systematically summarize the medical literature regarding the association between menopausal status and uterine bleeding and the risk of malignancy among patients with polyp resection. Methods Relevant articles assessing the risk of malignancy for patients undergoing polypectomy were identified from the Cochrane library, Pubmed, EMBASE, VIP Chinese Journal Database, and CNKI database. Key word were performed using the words ＂endometrial polyp＂, ＂malignancy＂, ＂ultrasound＂ or ＂hysteroscopy＂ or ＂histopathology＂. Estimates of relative risk with 95% confidence intervals （95% CI） were calculated by random-effects models. Homogeneity was tested across the studies. Results Nineteen studies met inclusion criteria for this review. There were 12 431 patients with endometrial polyp in this Meta-analysis. The overall rate of malignancy among all women with endometrial polyps in this Meta-analysis was 3.44% （428/12 431）. The symptomatic uterine bleeding was a statistically significant factor affected the malignancy of endometrial polyps （Z=3.72, P〈0.05; RR=2.14, 95%CI：1.43-3.20）. Similarly, the menopausal status was also a statistically significant factor which affected the malignancy of endometrial polyps （Z=7.64, P〈0.05; RR=4.25, 95%CI：2.93-6.17）. Conclusion Both symptomatic uterine bleeding and postmenopausal status in women with endometrial polyps are associated with an increased risk of endometrial malignancy.