绝经后女性子宫内膜息肉发生癌前病变及癌的危险因素分析

Endometrial polyps in postmenopausal women: factors associated with premalignancy/malignancy

关键词:  绝经后  子宫内膜息肉  恶变  危险因素  宫腔镜

Key words:  postmenopausal  endometrial polyps  malignant  risk factors  hysteroscopy

摘要:

目的　探讨绝经后女性无症状及有症状子宫内膜息肉的恶变率及危险因素。方法　选择经宫腔镜下内膜息肉摘除术的年龄＞45岁的绝经后女性161例，其中81例无症状，80例绝经后有不正常阴道流血。回顾性分析两组患者的临床资料，并根据病理结果进一步分为良性组和癌前/癌组，分别评估绝经后无症状及有症状子宫内膜息肉恶变与各临床指标的关系。结果　无症状组恶变率为2%，有症状组恶变率为12%，两组间恶变率无明显差异，P>0.05；肥胖（BMI≥28 kg/m²）和超声见血流信号在良性组和癌前/癌组间差异有显著性意义(P<0.05）。结论　绝经后子宫内膜息肉无症状女性与有症状女性在恶变率上无明显差异；绝经后女性子宫内膜息肉恶变与肥胖（BMI≥28 kg/m²）和超声提示血流信号有关。

Abstract:

Objective To explore the prevalence of malignant polyps and the factors associated with malignancy of endometrial polyps in asymptomatic and symptomatic postmenopausal women，in order to provide new thoughts of treatment for endometrial polyps in postmenopausal women.Methods Postmenopausal women (＞45 years of age)，who were treated by hysteroscopic resection of endometrial polyps，were enrolled in the study.Totally，81 asymptomatic and 80 consecutive postmenopausal women with abnormal uterine bleeding were included.Clinical data and pathologic reports of these patients were retrospectively analyzed to estimate the factors associated with malignancy of endometrial polyps in asymptomatic and symptomatic postmenopausal women，respectively.Results In the asymptomatic group and the symptomatic group，the prevalence of malignant polyps were.2% and2%，respectively，and no statistically significance was found between the two groups.Obesity (BMI≥28 kg/m) and blood flow presented by ultrasound were found statistically significant between the benign group and the premalignant/malignant group.Conclusion There is no statistical significance found on the prevalence of malignant polyps between asymptomatic group and symptomatic group in postmenopausal women.Obesity (BMI≥28 kg/m) and blood flow presented by ultrasound are the independent risk factors associated with malignancy of endometrial polyps in postmenopausal women.