子宫内膜厚度及绝经时间预测阴道出血及子宫内膜癌的价值  

Clinical significance of endometrial thickness and postmenopausal period for predicting endometrial cancer in patients with postmenopausal bleeding

作　　者：王家刚[1] 柯斌[1] 周瑞莉[1] 潘丽玲[1] 

机构地区：[1]广东省汕头市中心医院超声室,515031

出　　处：《中华医学超声杂志（电子版）》2006年第4期232-233,共2页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨绝经后子宫内膜厚度及绝经时间对内膜癌的预测价值。方法127例绝经后阴道出血患者内膜活检术前采用经阴道超声测量子宫内膜厚度,比较良、恶性组患者的发病年龄、平均内膜厚度,并对子宫内膜癌与内膜厚度及绝经时间的关系进行分析。结果127例患者(良性病变115例、内膜癌12例)经阴道超声测量,内膜癌组的平均内膜厚度(14.3±7.3)mm大于内膜良性病变组(7.0±4.4)mm(P<0.01)。其中内膜厚度≥10mm者内膜癌9例(9/45);内膜厚度≤5mm者无一例内膜癌。绝经后1～5年阴道出血者内膜厚度≤8mm、绝经5～15年阴道出血者内膜厚度≤6mm、绝经15年以上阴道出血内膜厚度≤5mm者发生内膜癌的可能性较小。结论内膜厚度及绝经时间与内膜癌的发生有相关性,随着绝经时间及内膜厚度的增加其发病率也增加。超声测量内膜厚度可减少绝经后阴道出血患者的内膜活检率。Objective To assess the value of endometrial thickness measured by transvaginal sonography (TVS) and postmenopausal period for predicting the possibility of endometrial cancer in women with postmenopausal bleeding. Methods All 127 women with postmenopausal bleeding underwent sonographic measurement of endometrial thickness and endometrial biopsy. In 127 cases, benigh lesions in 115 cases, endometrial carcinoma in 12. The age and mean endometrial thickness of the study group were compared with the benign (B) group. The endometrial thickness and postmenopausal period of the malignant (M) group were analyzed. Results The mean endometrial thickness measured from TVS was significantly thinner in the B group (7.0±4.4)mm than in the M group (14.3±7.3 mm, P< 0.01). No patient had carcinoma when the endometrium was ≤5 mm in thickness, but 20% (9/45) patients did when the thickness exceeded 10 mm. The cancer incidence was very low in women with menopause <5 years and endometrial thickness ≤8 mm, or menopause 5~15 years and thichness ≤6 mm, or menopause >15 years and thickness ≤5 mm. Conclusions The incidence of endometrial carcinoma is related to endometrial thickness and period of menopause. Cancer incidence will be increased along with the increasing endometrial thickness and increasing menopause period.

关 键 词：子宫内膜 绝经 子宫内膜肿瘤 出血 腔内超声检查 

分 类 号：R737.33[医药卫生—肿瘤]