Abstract
The RNA-binding protein LIN28B is an important factor for cell proliferation. Because LIN28B polymorphisms have been shown to be relative with the recurrence of some hyperplastic diseases, we hypothesized that genetic variants of LIN28B gene were associated with postoperative recurrence risk in reproductive-age women with endometrial polyps (EP). In a hospital-based cohort of 351 reproductive female patients underwent hysteroscopic polypectomies between May 2018 and Jan 2020, we genotyped two common polymorphisms in LIN28B gene (rs369065 C > T and rs314280 A > G) and analyzed their associations with the risk of postoperative recurrence in multiple Cox regression model. When followed up to Jun 2021, carries of rs369065 TT genotype had an increased risk of polyp recurrence (adjusting hazard ratio [HR] = 1.883, 95% confidence interval [CI] = 1.033 − 3.434) and had a shorter time to recurrence (median time 352 vs. 342 days, log-rank P < 0.01), compared to the CC/CT genotype. Further stratification analysis showed that the increased risk of rs369065 TT genotype was more evident in patients who were older than 33 years (adjusted HR = 2.597, 95%CI = 1.037 − 6.505), had a single polyp (adjusted HR = 2.545, 95%CI = 1.059 − 6.113), and had smaller polyps (<1.2 cm, adjusted HR = 2.708, 95%CI = 1.042 − 7.043). However, no significant association between rs314280 A > G polymorphism and the risk of polyp recurrence was found. Our study suggests that rs369065 TT genotype of LIN28B gene is associated with an increased postoperative recurrence risk in EP patients, especially in those with fewer and smaller polyps. These findings implicate a precise choice of clinical counseling and decision making. Larger studies in different ethnic populations are warranted.
Highlights
Endometrial polyp (EP) is a focal hyperplasia of endometrial basal layer, composing of endometrial glands, vessels, and nearby stroma [1]
We found that rs369065 TT genotype of LIN28B gene was associated with an increased postoperative recurrence risk of EP in reproductive-age women, and the deleterious role of rs369065 TT genotype in recurrence risk was more evident in the subgroups older than 33 years, and those with fewer and smaller polyps
We found that LIN28B rs 369065 C > T polymorphism was significantly associated with an increased risk of polyp recurrence in this study
Summary
Endometrial polyp (EP) is a focal hyperplasia of endometrial basal layer, composing of endometrial glands, vessels, and nearby stroma [1]. It is a common gynecologic disease with higher prevalence in infertile women [2]. Hysteroscopic polypectomy is commonly used to treat EP in infertile patients, which can improve spontaneous conception as well as assisted reproduction [2–4]. The rate of polyp recurrence after polypectomy remains 2.5 ~ 44%, which hinders the improvement of fertility in these patients [2–5]. Limited reports to explore risk factors of polyp recurrence are available, mostly focused on postmenopausal women [1]. A few studies conducted in reproductiveage women have suggested some risk factors, such as the duration of follow-up, the number and size of polyps, and sex hormone therapy [2–4, 6]. The biomarkers for hyperplasia of endometrial squamous cells should be further studied
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