Aiym Kaiyrlykyzy1, Kyle E Freese2, Esther Elishaev3, Dana H Bovbjerg4, Ramesh Ramanathan5, Giselle G Hamad5, Carol McCloskey5, Andrew D Althouse6, Marilyn Huang6, Robert P Edwards6, Faina Linkov7. 1. Center for Life Sciences, Nazarbayev University, Astana, Kazakhstan. 2. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, PA. 3. Department of Pathology, Magee-Womens Hospital, Pittsburgh, PA. 4. University of Pittsburgh Cancer Institute, Pittsburgh, PA. 5. Division of General Surgery, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA. 6. Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, PA. 7. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, PA. Electronic address: linkfy@mail.magee.edu.
Abstract
BACKGROUND: Endometrial pathology risk has been linked to obesity; however, little is known of its prevalence in severely obese women not seeking care for endometrial pathology associated symptoms. This pilot study was designed to explore the frequency and risk factors associated with endometrial pathology in cancer-free, severely obese, bariatric surgery candidates using the Pipelle endometrial sampling technique (SureFlex Preferred Curette, Bioteque America, Inc, New Taipei City, Taiwan). METHODS: Twenty-nine severely obese bariatric surgery candidates with intact uteruses and no history of endometrial cancer or endometrial ablation were included in this subanalysis from a larger cohort of 47. Endometrial samples were obtained using a Pipelle endometrial suction curette at a single time point before surgery. Logistic regression was used to assess the relationship between body mass index and endometrial pathology when adjusting for age and race. RESULTS: Of the 29 successful biopsies, 8 (27.6%) were classified as abnormal endometrium: 1 was classified as complex atypical hyperplasia, 1 was classified as hyperplasia without atypia, 4 samples were identified with endometrial polyps, and 2 samples were identified with metaplasia. None presented with cancer. Increasing body mass index was significantly associated with higher risk of abnormal endometrium (OR = 1.19, 95% CI [1.03-1.36], P = .01). CONCLUSIONS: The findings in this sample suggest that obesity may be associated with increased risk of having undiagnosed endometrial pathology. More thorough examination of relationships between levels of obesity and endometrial pathology are needed to better characterize high cancer risk groups who may benefit from introducing new screening measures.
BACKGROUND: Endometrial pathology risk has been linked to obesity; however, little is known of its prevalence in severely obesewomen not seeking care for endometrial pathology associated symptoms. This pilot study was designed to explore the frequency and risk factors associated with endometrial pathology in cancer-free, severely obese, bariatric surgery candidates using the Pipelle endometrial sampling technique (SureFlex Preferred Curette, Bioteque America, Inc, New Taipei City, Taiwan). METHODS: Twenty-nine severely obese bariatric surgery candidates with intact uteruses and no history of endometrial cancer or endometrial ablation were included in this subanalysis from a larger cohort of 47. Endometrial samples were obtained using a Pipelle endometrial suction curette at a single time point before surgery. Logistic regression was used to assess the relationship between body mass index and endometrial pathology when adjusting for age and race. RESULTS: Of the 29 successful biopsies, 8 (27.6%) were classified as abnormal endometrium: 1 was classified as complex atypical hyperplasia, 1 was classified as hyperplasia without atypia, 4 samples were identified with endometrial polyps, and 2 samples were identified with metaplasia. None presented with cancer. Increasing body mass index was significantly associated with higher risk of abnormal endometrium (OR = 1.19, 95% CI [1.03-1.36], P = .01). CONCLUSIONS: The findings in this sample suggest that obesity may be associated with increased risk of having undiagnosed endometrial pathology. More thorough examination of relationships between levels of obesity and endometrial pathology are needed to better characterize high cancer risk groups who may benefit from introducing new screening measures.
Authors: Kyle E Freese; Andrew D Althouse; Ramesh Ramanathan; Robert P Edwards; Dana H Bovbjerg; Faina Linkov Journal: Bariatr Surg Pract Patient Care Date: 2017-06-01 Impact factor: 0.607
Authors: Nancy Lu; Shalkar Adambekov; Robert P Edwards; Ramesh C Ramanathan; Dana H Bovbjerg; Faina Linkov Journal: Bariatr Surg Pract Patient Care Date: 2019-09-24 Impact factor: 0.607
Authors: V Grzegorczyk-Martin; T Fréour; A De Bantel Finet; E Bonnet; M Merzouk; J Roset; V Roger; I Cédrin-Durnerin; R Wainer; C Avril; P Landais Journal: Hum Reprod Date: 2020-12-01 Impact factor: 6.918
Authors: Michelle L MacKintosh; Abigail E Derbyshire; Rhona J McVey; James Bolton; Mahshid Nickkho-Amiry; Catherine L Higgins; Martyna Kamieniorz; Philip W Pemberton; Bilal H Kirmani; Babur Ahmed; Akheel A Syed; Basil J Ammori; Andrew G Renehan; Henry C Kitchener; Emma J Crosbie Journal: Int J Cancer Date: 2018-11-20 Impact factor: 7.396