【摘要】 目的:分析绝经后子宫内膜增厚病例的临床特点,探讨子宫内膜癌的相关危险因素。方法:收集清华大学第一附属医院2011年1月~2014年12月收治的348例绝经后子宫内膜增厚患者临床资料,按子宫内膜病变性质分为良性增生组、不典型增生组和子宫内膜癌组,分析子宫内膜厚度、绝经年龄、阴道出血、生育史、体重指数、高血压等临床指标与子宫内膜恶性病变的关系。结果:3组间子宫内膜厚度≥10mm、绝经年龄≥55岁、有阴道出血或排出粘液、合并高血压患者比例均有显著性差异(P<0.05,P<0.01)。多因素回归分析,绝经年龄(OR=1.12,95%CI 1.02-1.24)、高血压(OR=3.34,95%CI 1.13-9.80)、子宫内膜厚≥10mm(OR=2.48,95%CI 1.14-5.29)、阴道出血或粘液(OR=10.52,95%CI 3.91-27.78)与子宫内膜癌风险显著正相关;绝经年限≥10年(OR=0.33,95%CI 0.12-0.92)与子宫内膜癌风险显著负相关。有生育史与子宫内膜癌风险边缘性负相关;子宫内膜不典型性增生除与子宫内膜厚≥10mm、阴道出血或粘液显著正相关外,还与体重指数显著正相关。结论:子宫内膜增厚人群中,除子宫内膜厚度≥10mm、有阴道出血或粘液外,绝经年龄>55岁且绝经年限<10年、合并高血压或肥胖是增加绝经后子宫内膜癌风险的危险因素,相应人群宜常规行宫腔镜检查,以利早期发现。更多还原

【Abstract】 Objective:To investigate the clinical characteristics of endometrial thickening patients in order to improve the early diagnosis of endometrial lesions in postmenopausal women.Methods:Three hundred and forty-eight cases of postmenopausal women with endometrial thickening were recruited from January 2011 to December 2014.All patients were stratified to normal, malignant hyperplasia and cancer group according to endometrial lesions.Relationship between the endometrial thickness,colporrhagia,menopausal age,body mass index,birth history,hypertension and endometrial cancer were analyzed.Results:The proportion of endometrial thickness ≥10mm,menopausal age ≥55 years,colporrhagia,hypertension were significantly different among the three groups(P<0.05,P<0.01).Multivariable Logistic regression showed that the menopausal age(OR=1.12,95%CI 1.02-1.24),hypertension(OR =3.34,95% CI 1.13- 9.80),endometrial thickness ≥10mm(OR =2.48,95% CI1.14-5.29),colporrhagia(OR=10.52,95%CI 3.91-27.78)and duration of menopausal≥10 years(OR=0.33,95%CI0.12-0.92)were significantly associated with the risk of endometrial cancer.The endometrial malignant hyperplasia was also associated with body mass index,the endometrial thickness ≥10mm and colporrhagia.Conclusion:Patients with endometrial thickness greater than 10 mm,colporrhagia,late menopausal age with short duration of menopausal and hypertension have higher odd ratio with the endometrial cancer.Timely hysteroscopy examination for those patients may favor the early diagnosis.更多还原