Morphologic determinants of recurrent endometrial polyps in women of reproductive age

• Mekan R. Orazov
• Lyudmila M. Mikhaleva
• Olga А. Poymanova

Abstract

Endometrial polyps are a common nosology that, although often asymptomatic, is associated with reproductive dysfunction. Hysteroresectoscopic removal of polyps is an effective treatment, but recurrence is not uncommon. The recurrence rate after polypectomy according to different studies varies from 13 to 43%. As predisposing factors, such characteristics as hyperplastic type of polyps, a larger initial number of polyps and the duration of dynamic follow-up are emphasized. A detailed analysis of the histological features of the removed polyps will optimize the management of patients after polypectomy for the timely detection and treatment of recurrences.

The aim of the study was to expand the understanding of the pathogenesis of recurrent endometrial polyps in women of reproductive age.

Material and methods. 94 women with primary endometrial polyps [median age 37.58 years (Q₁–Q₃: 33.543–40.242)] and 96 women with endometrial polyp recurrence [median age 36 years (Q₁–Q₃: 34.30–37.99)] were included in a prospective cohort comparative open study. We collected anamnesis, anthropometric data, performed sonographic examination of the pelvic organs, hysteroscopy of the uterine cavity with targeted biopsy of the endometrium, morphologic and immunohistochemical examination.

Results. The expression level of the CD138 marker in the recurrent polyp group was 8 times higher compared to the primary polyp group, and the CD20 marker was 1.5 times higher (p<0.001).

Conclusion. Abnormal expression of CD138 and CD20 in the basal layer of the endometrium indicates the persistence of inflammation as a key factor in the development of endometrial polyp recurrence.

Keywords: endometrial polyps; recurrence; immunohistochemical

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