Endometrial histology in severely obese bariatric surgery candidates

An exploratory analysis

Aiym Kaiyrlykyzy, Kyle E. Freese, Esther Elishaev, Dana H. Bovbjerg, Ramesh Ramanathan, Giselle G. Hamad, Carol McCloskey, Andrew D. Althouse, Marilyn Huang, Robert P. Edwards, Faina Linkov

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)653-658
Number of pages6
JournalSurgery for Obesity and Related Diseases
Volume11
Issue number3
DOIs
Publication statusPublished - May 1 2015

Fingerprint

Bariatric Surgery
Histology
Pathology
Obesity
Endometrium
Hyperplasia
Body Mass Index
Endometrial Ablation Techniques
Neoplasms
Suction
Metaplasia
Endometrial Neoplasms
Polyps
Taiwan
Uterus
Logistic Models
Biopsy

Keywords

  • Bariatric surgery
  • Endometrial cancer
  • Endometrial hyperplasia
  • Endometrial polyps
  • Obesity
  • Pipelle sampling

ASJC Scopus subject areas

  • Surgery

Cite this

Kaiyrlykyzy, A., Freese, K. E., Elishaev, E., Bovbjerg, D. H., Ramanathan, R., Hamad, G. G., ... Linkov, F. (2015). Endometrial histology in severely obese bariatric surgery candidates: An exploratory analysis. Surgery for Obesity and Related Diseases, 11(3), 653-658. https://doi.org/10.1016/j.soard.2014.12.010

Endometrial histology in severely obese bariatric surgery candidates : An exploratory analysis. / Kaiyrlykyzy, Aiym; Freese, Kyle E.; Elishaev, Esther; Bovbjerg, Dana H.; Ramanathan, Ramesh; Hamad, Giselle G.; McCloskey, Carol; Althouse, Andrew D.; Huang, Marilyn; Edwards, Robert P.; Linkov, Faina.

In: Surgery for Obesity and Related Diseases, Vol. 11, No. 3, 01.05.2015, p. 653-658.

Research output: Contribution to journalArticle

Kaiyrlykyzy, A, Freese, KE, Elishaev, E, Bovbjerg, DH, Ramanathan, R, Hamad, GG, McCloskey, C, Althouse, AD, Huang, M, Edwards, RP & Linkov, F 2015, 'Endometrial histology in severely obese bariatric surgery candidates: An exploratory analysis', Surgery for Obesity and Related Diseases, vol. 11, no. 3, pp. 653-658. https://doi.org/10.1016/j.soard.2014.12.010
Kaiyrlykyzy, Aiym ; Freese, Kyle E. ; Elishaev, Esther ; Bovbjerg, Dana H. ; Ramanathan, Ramesh ; Hamad, Giselle G. ; McCloskey, Carol ; Althouse, Andrew D. ; Huang, Marilyn ; Edwards, Robert P. ; Linkov, Faina. / Endometrial histology in severely obese bariatric surgery candidates : An exploratory analysis. In: Surgery for Obesity and Related Diseases. 2015 ; Vol. 11, No. 3. pp. 653-658.
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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.",
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AU - Freese, Kyle E.

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AU - Ramanathan, Ramesh

AU - Hamad, Giselle G.

AU - McCloskey, Carol

AU - Althouse, Andrew D.

AU - Huang, Marilyn

AU - Edwards, Robert P.

AU - Linkov, Faina

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N2 - 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.

AB - 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.

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