绝经后子宫内膜息肉的临床特征、超声特点与病理分析及预测模型建立  

The clinical features,ultrasound imaging features,pathological analysis and establishment of predictive model of postmenopausal endometrial polyps

作　　者：徐阳峰 黄青 周乔芳 Xu Yangfeng

机构地区：[1]宁波市医疗中心李惠利医院,315000

出　　处：《浙江临床医学》2022年第7期979-981,共3页Zhejiang Clinical Medical Journal

摘　　要：目的分析绝经后子宫内膜息肉患者的临床特征、超声影像特点与病理的相关性.方法选取2020年1月至2021年5月绝经后子宫内膜息肉患者147例,分析临床特征、超声影像特点与病理诊断的相关性.结果病理结果显示,147例子宫内膜息肉中,良性组119例,恶性组28例.恶性组和良性组年龄、绝经年龄、初潮年龄、孕次、产次、雌二醇水平、恶性肿瘤个人史/家族史比较,差异无统计学意义(P>0.05);恶性组绝经后出血次数≥2、糖尿病、高血压、肥胖(BMI≥28)、息肉≥1 cm和息肉伴血流信号、内膜厚度及息肉直径占比明显高于良性病变组,差异有统计学意义(P<0.05).通过纳入绝经出血次数≥2次、息肉B超回声、息肉伴血流信号这3项指标建立列线图预测模型,此模型的患者工作特征曲线(receiver operating characteristic curve,ROC)的曲线下面积为0.971.结论绝经后出血次数≥2次、超声提示伴血流信号的息肉是子宫内膜息肉恶变的独立风险因素,临床中需要对此类患者保持高度警惕.Objective To explore the relationship between the clinical features,ultrasound imaging features and pathological diagnosis of postmenopausal endometrial polyps.Methods 147 patients with suspected postmenopausal endometrial polyps who were treated in our hospital from January 2020 to May 2021 were selected for research.Analyze the correlation between the clinical features,ultrasound imaging features and pathological diagnosis.Results The pathological results showed that among 147 endometrial polyps,119 were benign and 28 were malignant.The results showed that there was no statistical difference between the age,age at menarche,age at menopause,pregnancy,parity,estradiol level,asymptomatic,malignant tumor history between the malignant lesion group and the benign lesion group(P>0.05).The number of bleeding in the malignant lesion group≥2,diabetes,hypertension,obesity,polyps≥1cm,intimal thickness and polyp diameter and the proportion of blood flow signal were significantly higher than those in the benign lesion group,and the difference was statistically significant(P<0.05).A prognostic nomogram was constructed by including three indicators of menopausal bleeding≥2 times,polyp B-ultrasound echo,and polyp with blood flow signal.The area under the curve of the receiver operating characteristic curve(ROC)of this model was 0.971.Logistic regression analysis showed that postmenopausal bleeding times≥2 and polyps with blood flow signals were independent risk factors for postmenopausal endometrial malignancy,and hyperechoic polyps suggested by ultrasound was independent protective factor for postmenopausal endometrial malignancy.Conclusion Polyps with bleeding times≥2 after menopause and ultrasound-prompted with blood flow signals are independent risk factors for endometrial polyps malignancy,which is needed high vigilance in clinical practice for such patients.

关 键 词：绝经后子宫内膜息肉 临床特征 超声特点 病理诊断 预测模型 

分 类 号：R711.74[医药卫生—妇产科学]