摘要
目的:探讨子宫内膜不典型增生(AEH)术后病理升级的相关因素及合理治疗方案。方法:回顾分析术前诊断性刮宫病理诊断为AEH并行全子宫切除术的104例患者的临床病理资料。根据术后病理结果:分为非子宫内膜癌组(70例)和子宫内膜癌组(34例),分析患者的临床病理特征,计算预测患者病理升级的危险因素。结果:术前诊断为AEH的患者中,32.69%(34例)术后病理升级为子宫内膜癌。单因素分析显示,绝经状态及超声I级以上血流信号是术后病理升级的相关因素(P<0.05)。肿瘤浸润子宫肌层深度与超声下血流丰富程度呈正相关(r=0.548,P=0.001)。多因素分析显示,I级以上血流信号是术后病理升级的危险因素。结论:诊断性刮宫取材诊断的AEH患者术后病理升级较为常见,伴有I级以上血流信号的患者术前需仔细评估,以制定更合理的诊疗方案。
Objective:To explore the related factors and reasonable treatment of postoperative pathological escalation in atypical endometrial hyperplasia(AEH)patients.Method:Hysterectomy was performed in 104 patients with AEH diagnosed by diagnostic curettage(D&C).According to pathology after hysterectomy,the patients were divided into two groups:the non-endometrial carcinoma group(n=70)and the endometrial carcinoma group(n=34).The differences in clinicopathological factors between them were statistically analyzed.Result:The incidence of AEH with EC was approximately 32.69%(34/104).Univariate analysis found that postmenopausal status and blood flow signals above grade I diagnosed by ultrasound were the risk factors of postoperative pathological escalation(P<0.05).There was a positive correlation between the depth of tumor invasion into myometrium and the richness of blood flow under ultrasound(r=0.548,P=0.001).Multivariate analysis showed that blood flow signal above grade I were risk factors for postoperative pathological escalation.Conclusion:Postoperative pathological escalation of AEH patients diagnosed by D&C is more common.Patients with blood flow signals above grade I diagnosed by ultrasound need careful preoperative evaluation to formulate a more reasonable diagnosis and treatment option.
作者
钟艺
袁琳
张林
杨静
聂祥琳
万一聪
马小玲
程文俊
Zhong Yi;Yuan Lin;Zhang Lin(Department of Gynecology,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029)
出处
《现代妇产科进展》
CSCD
北大核心
2022年第7期496-498,503,共4页
Progress in Obstetrics and Gynecology
基金
国家自然科学基金面上项目(No:81872119、82103286)
江苏省中医药科技发展项目(No:ZD202014)
江苏省“333工程”科研项目(No:2019)
江苏省医学创新团队(No:CXTDA201708)
江苏省基础研究计划(自然科学基金)青年基金项目(No:BK20210971)
江苏省高等学校自然科学研究面上项目(No:20KJB320016)
江苏省妇幼保健协会科研项目(No:FYX201909)。
关键词
子宫内膜不典型增生
子宫内膜癌
病理升级
相关因素
Atypical endometrial hyperplasia
Endometrial carcinoma
Pathological escalation
Related factors
