绝经过渡期子宫内膜息肉恶变影响因素研究  

Influencing Factors for Malignancy in Perimenopausal Women with Endometrial Polyps

作　　者：赵剑虹[1] 沈岚[1] 刘玲[1] 蒋希菁[1] 陈丽[1] 

机构地区：[1]浙江省中西医结合医院妇产科,浙江省杭州市310003

出　　处：《中国全科医学》2014年第14期1625-1628,共4页Chinese General Practice

摘　　要：目的探讨绝经过渡期子宫内膜息肉(EP)发生恶变的影响因素。方法选取2008年6月—2013年6月在浙江省中西医结合医院妇产科行宫腔镜检查,同时行宫腔镜下EP切除术,术后病理确诊为EP的患者884例。根据绝经状态、年龄将患者分为年龄<40岁组519例、绝经过渡期组209例、绝经后组156例。采用单因素和多因素Logistic回归分析筛选EP患者和绝经过渡期EP患者发生恶变的影响因素。结果 884例EP患者恶变率为2.26%(20/884)。3组年龄〔(32.3±15.4)岁、(43.9±7.6)岁与(57.9±10.3)岁〕和恶变率〔0.39%(2/519)、4.78%(10/209)与5.13%(8/156)〕比较,差异均有统计学意义(P<0.05)。EP恶变影响因素单因素分析结果显示,绝经后及绝经过渡期与EP恶变相关(P<0.05);多因素Logistic回归分析结果显示,绝经过渡期、复发性EP、>10 mm息肉、异常子宫内膜出血(AUB)、合并子宫内膜异位症或腺肌症与EP恶变有回归关系(P<0.05)。绝经过渡期EP恶变影响因素单因素分析结果显示,复发及AUB与绝经过渡期EP恶变有关(P<0.05);多因素Logistic回归分析结果显示,绝经状态、息肉数量、类型、大小、合并高血压、合并糖尿病、BMI、AUB、子宫内膜异位症或腺肌症与绝经过渡期EP恶变均无回归关系(P>0.05)。结论绝经过渡期及绝经后患者EP恶变的危险性增加,绝经过渡期、复发性EP、>10 mm息肉、AUB、合并子宫内膜异位症或腺肌症是EP恶变的独立危险因素。未发现绝经过渡期EP恶变的明显影响因素。Objective To investigate the influencing factors for malignancy in perimenopausal women with endometrial polyps（EP）.Methods A total of 884 EP patients identified by histopathology underwent hysteroscopic polypectomy in the Department of Obstetrics and Gynecology,the Combine Traditional Chinese and Western Medicine Hospital of Zhejiang from June 2008 to June 2013 were selected.According to age and menopausal status,the patients were divided into under 40 group（519 cases）,menopausal transition group（209 cases） and postmenopausal group（156 cases）.Results Malignant transformation was found in 2.26%（20 /884） patients.According to age groups 〔（32.3 ± 15.4） vs.（43.9 ± 7.6） vs.（57.9 ± 10.3） years〕and malignancy rate 〔0.39%（2 /519） vs.4.78%（10 /209） vs.5.13%（8 /156） 〕,there was statistically significant difference（P〈0.05）.Postmenopausal and menopausal transition were associated with malignant transformation of EP（P〈0.05）.Multivariate Logistic regression analysis showed that menopausal transition,abnormal uterine bleeding,recurrent EP,and the presence of endometriosis or adenomyosis were associated with EP malignant transformation（P〈0.05）.Additionally,single factor analysis showed that the malignancy rate of EP in patients in menopausal transition was higher for recurrent EP and EP with abnormal uterine bleeding（P〈0.05）.Multivariate Logistic regression analysis showed that no factor had a relationship with the menopausal transition in EP malignant transformation（P〈0.05）.Conclusion Postmenopausal and menopausal transition status are associated with an increased risk of Epmalignant transformation.Menopausal transition,recurrent EP,polyps greater than 10 mm in size,abnormal uterine bleeding,and combination with endometriosis or adenomyosis are associated with a higher risk for malignant lesions.

关 键 词：子宫内膜息肉 绝经过渡期 恶变 影响因素 

分 类 号：R711.71[医药卫生—妇产科学]