子宫内膜癌及癌前病变危险因素的调查研究  

Investigation on risk factors of endometrial carcinomas and atypical endometrial hyperplasia

作　　者：杨曦[1] 吴成[1] 张乃怿[1] 赵健[1] 董颖[2] 张楠[1] 廖秦平[1] 

机构地区：[1]北京大学第一医院妇产科,北京100034 [2]北京大学第一医院病理科,北京100034

出　　处：《现代妇产科进展》2013年第7期553-556,共4页Progress in Obstetrics and Gynecology

基　　金：北京市科学技术委员会;首都临床特色应用研究<提高宫腔细胞学筛查子宫内膜癌准确性的临床研究>(No:D101100050010047);2009年度首都医学发展科研基金<宫腔细胞学筛查子宫内膜癌的临床研究>(No:2009-1010)

摘　　要：目的:研究子宫内膜癌(EC)及癌前病变的流行病学特征及其发病的高危因素,为明确EC筛查的适宜人群提供依据。方法:选取2009年3月到2010年7月在北京大学第一医院妇产科行宫腔镜检查+分段诊刮术且同时行子宫内膜细胞学检查的540例患者。比较组织病理学诊断与子宫内膜细胞学筛查的结果。采用SPSS10.0软件二分类非条件Logistic回归分析对影响组织病理学与子宫内膜细胞学结果的高危因素进行分析。结果:组织病理学结果为EC/非典型增生的相关危险因素:BMI≥25kg/m2、年龄≥40岁、糖尿病、高血压、绝经、恶性肿瘤家族史和毒物放射线接触史;独立危险因素:BMI≥25kg/m2、年龄≥40岁、糖尿病和恶性肿瘤家族史。子宫内膜细胞学报告为非典型腺细胞以上的相关危险因素:BMI≥23kg/m2、年龄≥40岁、糖尿病、高血压、绝经和恶性肿瘤家族史;独立危险因素:BMI≥23kg/m2和年龄≥40岁。结论:建议对年龄≥40岁或恶性肿瘤家族史的患者中进行EC的筛查;对肥胖、糖尿病的患者加强子宫内膜状况的监测。子宫内膜细胞学报告与病理学诊断的高危因素谱基本相同。Objective ：Todetermine related characteristics and independent risk factors of epidemiology of endometrial carcinomas and atypical endometrial hyperplasia and to advise proper crowd for endometrial carcinomas screening and monitoring. Methods：540 preoperative questionnaires on hysteroscopy＋dilation and curettage, histopathology and endometrial cytologi- cal tests were collected in the Department of Obstetrics and Gynecology, Peking University First Hospital,from Mar 2009 to Jul. 2010. Binary Logistic regression method using SPSS 10.0 was applied to narrow down the risk factors of histopathology and endometrial cytological examina- tion. Results：Univariate analysis revealed that risk factors of diagnosis of endometrial carcino- mas and atypical hyperplasia of histopathology were ： BMI ≥25kg/m2, age ≥40y, diabetes melli- tus, hypertension, menopause, family history of malignant tumor and contact history of poison or radiation. Muhifactor analysis revealed the independent risk factors were： BMI ≥ 25kg/m2, age ≥40y, diabetes mellitus and family history of malignant tumor. Univariate analysis revealed that risk factors of diagnosis of atypical glandular cells or above were ： BMI ≥23kg/m2, age ≥40y, di- abetes mellitus, hypertension, menopause and family history of malignant tumor. Multifactor a- nalysis revealed the independent risk factors were： BMI ≥23kg/m2 and age ≥40y. Conclu- sions：We advise routine endometrial carcinomas screening of patients over 40 years old or with family history of malignant tumor, and intensified endometrial monitoring of patients with obesity or diabetes mellitus. Risk factor spectrums concluded from pathological diagnosis and cytological examination are consistent.

关 键 词：子宫内膜细胞学 子宫内膜癌 子宫内膜非典型增生 筛查 高危因素 

分 类 号：R737.33[医药卫生—肿瘤]