子宫内膜不典型增生的临床特征及合并子宫内膜癌的风险预测

发布时间：2018-03-05 16:05

  本文选题：子宫内膜不典型增生　切入点：子宫内膜癌　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究子宫内膜不典型增生的临床特征及合并子宫内膜癌的风险预测。方法:收集2007年1月至2017年1月因术前子宫内膜病理提示子宫内膜不典型增生而行全子宫切除术的171例患者的临床资料。根据全子宫切除术术后病理结果分为子宫内膜不典型增生(AEH)组(117例)和子宫内膜癌(EC)组(54例),回顾性比较两组的临床特征,同时用logistic回归对合并子宫内膜癌的风险进行预测。结果:1.单因素结果显示:子宫内膜不典型增生组在年龄、绝经状态、病理与子宫内膜癌组对比,差异有统计学意义(P0.05),而在高血压、糖尿病、血清CA125、血清CA199、内膜取样至全子宫切除手术日的平均时间间隔、分娩次数、内膜取样方法、术前阴道超声或MRI测定子宫内膜平均厚度、体重质量指数(BMI),差异无统计学意义(P0.05)。2.多因素结果显示:年龄≥51.5岁(OR=3.12,95%CI:1.59-6.14,P0.05)、已绝经(OR=3.39,95%CI:1.66-6.95,P0.05)、重度AEH(OR=4.46,95%CI:2.47-8.05,P0.05)是子宫内膜不典型增生合并子宫内膜癌的高危因素。3.子宫内膜不典型增生在不伴任何高危因素、伴1个高危因素、伴2个高危因素、伴3个高危因素上合并子宫内膜癌的患者占11.94%(8/67)、35.71%(20/56)、36.36%(8/22)、69.23%(18/26),差异有统计学意义(P0.05)。4.54例子宫内膜不典型增生合并子宫内膜癌患者占31.58%(54/171),有88.89%(48/54)为子宫内膜样腺癌I期,其中高分化占70.37%(38/54)。结论:1.子宫内膜不典型增生合并子宫内膜癌有较高的发生率,当临床上发现有异常阴道流血的患者,如果年龄≥51.5岁或已绝经或诊刮病理为重度子宫内膜不典型增生时发生子宫内膜癌的风险增加,要给予积极处理。2.子宫内膜不典型增生合并子宫内膜癌多为分化较好的I期子宫内膜样腺癌。
[Abstract]:Objective: to study the clinical features of endometrial atypical hyperplasia and the risk prediction of endometrial carcinoma. Methods: from January 2007 to January 2017, the clinical features of endometrial atypical hyperplasia were studied. The clinical data of 171 patients undergoing hysterectomy. According to the pathological results of total hysterectomy, they were divided into two groups: the endometrial atypical hyperplasia (AEH) group (n = 117) and the endometrial carcinoma (EC) group (n = 54). The clinical features of the two groups were compared retrospectively. At the same time, logistic regression was used to predict the risk of endometrial carcinoma. Results: the univariate results showed that the age, menopausal status, pathology of endometrial atypical hyperplasia group were compared with that of endometrial carcinoma group. The difference was statistically significant (P 0.05), while in hypertension, diabetes, serum CA125, serum CA199, the average interval between endometrial sampling and total hysterectomy, the number of deliveries, the method of endometrial sampling, the mean thickness of endometrium was measured by preoperative vaginal ultrasound or MRI. There was no significant difference in body mass index (BMI) (P 0.05). The multivariate results showed that the age 鈮，

本文编号：1570932