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Abstract：
BACKGROUND: To investigate the impact of chronic endometritis (CE) on the recurrence of endometrial polyps (EPs) in premenopausal women after transcervical resection of endometrial polyps (TCRP).
METHODS: This prospective study enrolled 507 women who underwent TCRP between January 1, 2022 and December 31, 2022. The patients were divided into a CE group (n = 133) and non-CE group (n = 374) based on the expression of CD138 in the endometrium. The EP recurrence rate at 1 year after TCRP was compared between the CE and non-CE groups and between groups with mild CE and severe CE. The impact of CD138 expression by resected EPs on EP recurrence also was investigated.
RESULTS: The EP recurrence rate at 1 year post-TCRP was higher in the CE group than in the non-CE group (25.6% vs. 10.4%) and also higher in the severe CE group than in the mild CE group (34.5% vs. 18.7%). Additionally, the EP recurrence rate was higher among patients with CD138-expressing EPs than among those with EPs lacking CD138 expression (30.5% vs. 6.5%). The odds ratio (OR) for EP recurrence in the CE cohort compared with the non-CE cohort was 3.10 (95% confidence interval [CI] 1.84-5.23) after adjustment for EP number and precautions against EP recurrence. The ORs for EP recurrence in patients with mild CE and severe CE were 2.21 (95%CI 1.11-4.40) and 4.32 (95%CI 2.26-8.26), respectively. Similarly, the OR for EP recurrence in cases with CD138-expressing EPs relative to cases with EPs lacking CD138 expression was 6.22 (95%CI 3.59-10.80) after adjustment for EP number and precautions against EP recurrence.
CONCLUSIONS: CE multiplied the recurrence rate of EPs in premenopausal women after TCRP, and this effect positively correlated with CE severity. CD138 expression by EPs also was associated with a higher risk for EP recurrence.
METHODS: This prospective study enrolled 507 women who underwent TCRP between January 1, 2022 and December 31, 2022. The patients were divided into a CE group (n = 133) and non-CE group (n = 374) based on the expression of CD138 in the endometrium. The EP recurrence rate at 1 year after TCRP was compared between the CE and non-CE groups and between groups with mild CE and severe CE. The impact of CD138 expression by resected EPs on EP recurrence also was investigated.
RESULTS: The EP recurrence rate at 1 year post-TCRP was higher in the CE group than in the non-CE group (25.6% vs. 10.4%) and also higher in the severe CE group than in the mild CE group (34.5% vs. 18.7%). Additionally, the EP recurrence rate was higher among patients with CD138-expressing EPs than among those with EPs lacking CD138 expression (30.5% vs. 6.5%). The odds ratio (OR) for EP recurrence in the CE cohort compared with the non-CE cohort was 3.10 (95% confidence interval [CI] 1.84-5.23) after adjustment for EP number and precautions against EP recurrence. The ORs for EP recurrence in patients with mild CE and severe CE were 2.21 (95%CI 1.11-4.40) and 4.32 (95%CI 2.26-8.26), respectively. Similarly, the OR for EP recurrence in cases with CD138-expressing EPs relative to cases with EPs lacking CD138 expression was 6.22 (95%CI 3.59-10.80) after adjustment for EP number and precautions against EP recurrence.
CONCLUSIONS: CE multiplied the recurrence rate of EPs in premenopausal women after TCRP, and this effect positively correlated with CE severity. CD138 expression by EPs also was associated with a higher risk for EP recurrence.
摘要：
背景：探讨慢性子宫内膜炎(CE)对绝经前妇女子宫内膜息肉(TCRP)术后子宫内膜息肉(EP)复发的影响。
方法：这项前瞻性研究纳入了在2022年1月1日至2022年12月31日期间接受TCRP的507名女性。根据CD138在子宫内膜的表达将患者分为CE组（n=133）和非CE组（n=374）。比较CE和非CE组之间以及轻度CE和重度CE组之间TCRP后1年的EP复发率。还研究了切除的EP的CD138表达对EP复发的影响。
结果：CE组TCRP术后1年的EP复发率高于非CE组（25.6％vs.10.4％），重度CE组也高于轻度CE组（34.5％vs.18.7%）。此外,表达CD138的EPs患者的EP复发率高于缺乏CD138表达的EPs患者(30.5%vs.6.5%）。在调整EP数量和预防EP复发的预防措施后，CE队列与非CE队列中EP复发的比值比（OR）为3.10（95％置信区间[CI]1.84-5.23）。轻度CE和重度CE患者EP复发的OR分别为2.21（95CI1.11-4.40）和4.32（95CI2.26-8.26），分别。同样，在调整EP数量和预防EP复发的预防措施后,表达CD138的EP的患者相对于缺乏CD138的EP的患者的EP复发OR为6.22(95CI3.59-10.80).
结论：CE乘以TCRP后绝经前妇女的EP复发率，这种效应与CE严重程度呈正相关。EPs的CD138表达也与较高的EP复发风险相关。
方法：这项前瞻性研究纳入了在2022年1月1日至2022年12月31日期间接受TCRP的507名女性。根据CD138在子宫内膜的表达将患者分为CE组（n=133）和非CE组（n=374）。比较CE和非CE组之间以及轻度CE和重度CE组之间TCRP后1年的EP复发率。还研究了切除的EP的CD138表达对EP复发的影响。
结果：CE组TCRP术后1年的EP复发率高于非CE组（25.6％vs.10.4％），重度CE组也高于轻度CE组（34.5％vs.18.7%）。此外,表达CD138的EPs患者的EP复发率高于缺乏CD138表达的EPs患者(30.5%vs.6.5%）。在调整EP数量和预防EP复发的预防措施后，CE队列与非CE队列中EP复发的比值比（OR）为3.10（95％置信区间[CI]1.84-5.23）。轻度CE和重度CE患者EP复发的OR分别为2.21（95CI1.11-4.40）和4.32（95CI2.26-8.26），分别。同样，在调整EP数量和预防EP复发的预防措施后,表达CD138的EP的患者相对于缺乏CD138的EP的患者的EP复发OR为6.22(95CI3.59-10.80).
结论：CE乘以TCRP后绝经前妇女的EP复发率，这种效应与CE严重程度呈正相关。EPs的CD138表达也与较高的EP复发风险相关。
