Specific hysteroscopic findings can efficiently distinguish the differences between malignant and benign endometrial polyps

Ngo, Yeh Giin; Fu, Hai-Xia; Chu, Li-Ching; Tseng, Chung Jen; Chen, Chao‐Yu; Lee, Chung‐Yuan; Ou, Yu‐Che

doi:10.1016/j.tjog.2019.11.013

Cited by 7 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are several studies which examined hysteroscopic findings of patients regardless of their history of TAM treatment. They indicated that hysteroscopic findings associated with malignancy were irregular or ulcerative surfaces, anarchic or diffuse vascularization, or papillary aspects 12, 13 …”

Section: Discussionmentioning

confidence: 99%

Atypical vessels in hysteroscopy: Usefulness in prediction of malignant diseases in patients treated with tamoxifen

Oka

Sakai

Yamagami

et al. 2021

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Aim Tamoxifen (TAM) is widely used in adjuvant endocrine therapy for invasive breast cancer as a selective estrogen modulator, but this treatment has a risk of developing endometrial malignancy. However, hysteroscopic findings during or after TAM treatment are unclear. The aim of this study is to examine the association between hysteroscopic patterns and malignant histological findings during or after treatment with TAM. Methods The subjects were patients who received TAM after surgery for breast cancer and underwent hysteroscopy at our institution from January 2016 to December 2019. Clinicopathological factors and hysteroscopic findings were collected from medical records and investigated retrospectively. Histologically, atypical endometrial hyperplasia, endometrial cancer, and carcinosarcoma were classified as malignant diseases. Results A total of 26 patients were eligible for the study. Hysteroscopic findings included an irregular surface of the endometrium (n = 3, 11.5%), atypical vessels (n = 10, 38.5%), papillary structure (n = 3, 11.5%), and polypoid structure (n = 18, 69.2%). Histological examination revealed malignancy in six patients (23.0%). The percentage of atypical vessels in patients with malignancies was significantly higher than that in patients with a normal endometrium or benign lesion (100% vs. 20%, p = 0.0009). The sensitivity and specificity of atypical vessels in hysteroscopy for diagnosis of malignant diseases were 100% and 80%, respectively. Conclusions Hysteroscopic findings of atypical vessels may be useful for prediction of malignant diseases in patients treated with TAM.

show abstract

Section: Discussionmentioning

confidence: 99%

Atypical vessels in hysteroscopy: Usefulness in prediction of malignant diseases in patients treated with tamoxifen

Oka

Sakai

Yamagami

et al. 2021

J of Obstet and Gynaecol

View full text Add to dashboard Cite

show abstract

“…Extended vessels are those extending to the top of the protrusion. Atypical vessels include those with meandering, expansion, inconsistent diameter, and disruption, frequently mentioned as features representing endometrial malignancy 4,6,10 . A white/yellow lesion indicates focal necrosis or microcalcifications on the endometrial surface 5 .…”

Section: Methodsmentioning

confidence: 99%

“…Atypical vessels include those with meandering, expansion, inconsistent diameter, and disruption, frequently mentioned as features representing endometrial malignancy. 4,6,10 A white/ yellow lesion indicates focal necrosis or microcalcifications on the endometrial surface. 5 An experienced consultant, blinded to the pathology results, retrospectively judged these five features as positive or negative using hysteroscopy videos.…”

Section: Hysteroscopymentioning

confidence: 99%

Characteristic hysteroscopy appearance considerations for detecting uterine endometrial malignancies

Matsumoto,

Yamaguchi,

Maruyama

et al. 2024

J of Obstet and Gynaecol

View full text Add to dashboard Cite

AimThe effectiveness of hysteroscopy in diagnosing endometrial lesions has been demonstrated, showing high diagnostic accuracy for malignant endometrial lesions. Although the characteristic appearances of atypical and malignant endometria have been reported, they are not definitive and sometimes complicated. This study aimed to identify a small number of characteristic features to detect endometrial abnormalities using a simple judgment system and analyze the diagnostic characteristics and their accuracy in endometrial malignancy diagnosis.MethodsWe performed a retrospective analysis of hysteroscopy video data of 250 patients, of which we selected for analysis based on pathology examination 152 cases with benign changes, 16 with atypical endometrium, and 18 with carcinoma in situ or endometrial cancer. Endometrial characteristics assessed included protrusion, desquamation, extended vessel, atypical vessel, and white/yellow lesion.ResultsMultivariable analysis revealed that desquamation (p = 0.001, odds ratio [OR] 5.28), atypical vessels (p < 0.001, OR 8.50), and white/yellow lesions (p = 0.011, OR 1.37) were significant predictors for endometrial malignancy. From their contribution status, scoring points of 4, 6, and 1 were settled according to the odds ratio proportions. When scores ≥5 (at least both desquamation and white/yellow lesions or only atypical vessels) were used to define endometrial malignancy, sensitivity and specificity were 100% and 92%, respectively. When detecting cancer, atypical, and benign cases, sensitivity and specificity were 88% and 90%, respectively.ConclusionOur characteristics hysteroscopic findings showed a higher predictive ability in detecting endometrial malignancies. However, further examination with more cases would be needed to accurately diagnose endometrial malignancy by hysteroscopy.

show abstract

“…Late menopause was defined as menopausal age >53 years. The appearance of EPs with crisp, prone to bleeding, irregular surfaces, ulcerative, and vascular abundance during hysteroscopy were considered as malignant signs (18).…”

Section: Methodsmentioning

confidence: 99%

Noninvasive Predictor for Premalignant and Cancerous Lesions in Endometrial Polyps Diagnosed by Ultrasound

Rao

Lü

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundThere was no consensus for management of asymptomatic endometrial polyps (EPs) up to date.ObjectiveThe aim of present study was to determine the risk factors of malignant lesions in EPs diagnosed by ultrasound and establish a noninvasive predictor to decrease unnecessary hysteroscopy for EPs.Study DesignWe reviewed the records of all consecutive patients who underwent hysteroscopy for EPs in the Women’s Hospital School of Medicine Zhejiang University between January 1, 2001 and December 31, 2018. The patients with histological diagnoses of atypical hyperplasia or cancer were defined as malignancy, while the patients with histological diagnoses of benign lesions were randomly selected as benign group according to the ratio of 1:4 (malignancy:benign), matching by age and year of hospitalization. Logistic regression analysis was used to analyze the clinical parameters for predicting malignancy of EPs. A Chi-squared automatic interaction detection (CHAID) decision tree analysis was performed to find a noninvasive predictor. The sensitivity, specificity, and the receiver operating characteristic curve (ROC) were used for assess the efficacy of the noninvasive predictor. New diagnosed EPs patients received in 2019 were used for verifying the accuracy of the noninvasive predictor.ResultsThe age in 15,790 cases of benign lesions was significantly younger than that in 230 malignancy cases (41.97 ± 11.53 year vs 53.31 ± 11.61 years, p <0.001). AUB (OR 7.306, 95%CI 4.927–10.835), large EPs (OR 2.595, 95%CI 1.662–4.052), and blood flow signal in EPs (OR 2.690, 95%CI 1.872–3.866) were independent predictive factors of malignancy in all enrolled patients. A noninvasive predictor for malignancy of EPs was established, through combining with AUB, large polyps and blood flow signal. This predictor presented excellent sensitivity and NPV (91.3 and 95.8%), with acceptable specificity and AUC (0.801). Further validation in new diagnosed EPs also suggested excellent sensitivity and reasonable specificity (100 and 58.5%) of the predictor. Factors such as thickened endometrial thickness, menopause shorter than 10 years, hypertension, obesity and nulliparous were also validated as independent predictors of malignancy in different subgroup analysis.ConclusionsThe noninvasive predictor combined with other risk factors from subgroup analysis would be reliable to distinguish the benign lesions from malignancy for EPs diagnosed by ultrasound.

show abstract

Specific hysteroscopic findings can efficiently distinguish the differences between malignant and benign endometrial polyps

Cited by 7 publications

References 16 publications

Atypical vessels in hysteroscopy: Usefulness in prediction of malignant diseases in patients treated with tamoxifen

Atypical vessels in hysteroscopy: Usefulness in prediction of malignant diseases in patients treated with tamoxifen

Characteristic hysteroscopy appearance considerations for detecting uterine endometrial malignancies

Noninvasive Predictor for Premalignant and Cancerous Lesions in Endometrial Polyps Diagnosed by Ultrasound

Contact Info

Product

Resources

About