临床特征在术前诊断子宫腺肌病合并子宫内膜癌中的作用  

Role of clinical characteristics in preoperative diagnosis of adenomyosis with endometrial cancer

作　　者：杨超逸 谭爱丽[1] Yang Chaoyi;Tan Aili(Dept of Obstetrics and Gynecology,Renmin Hospital of Wuhan University,Wuhan 430060)

机构地区：[1]武汉大学人民医院妇产科,武汉430060

出　　处：《安徽医科大学学报》2024年第5期885-889,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81801421)。

摘　　要：目的分析子宫腺肌病(AM)与合并子宫内膜癌(EC)患者的临床特征及在术前诊断中的作用。方法收集最终经病理检查确定为AM合并EC或子宫内膜非典型增生(EAH)以及同期有异常子宫出血(AUB)的AM患者共142例,根据是否合并EC或EAH分为AM合并EC或EAH组(71例)和对照组(71例),对患者的临床资料进行回顾性分析,探讨AM合并EC患者的临床特征及治疗策略的制定。结果单因素分析结果显示AM合并EC或EAH组患者的年龄、CA125及CA125升高的比例、子宫体积、合并高血压、超声存在内膜异常声像的比例均显著高于对照组,痛经的比例显著低于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,超声的内膜增厚、内膜回声不均、内膜增厚合并回声不均是AM合并EC或EAH的独立危险因素。结论临床上应对超声具有内膜增厚或回声不均声像的AM患者先行宫腔镜诊刮取得病理结果后再进一步制定手术方案,以达到早期诊治EC的目的。Objective To analyze the clinical characteristics of patients with adenomyosis(AM)and endometrial cancer(EC)and their role in preoperative diagnosis.Methods A total of 142 patients with AM complicated with EC or endometrial atypical hyperplasia(EAH)and AM with abnormal uterine bleeding(AUB)during the same period were collected from this hospital.They were divided into AM with EC or EAH group(71 cases)and control group(71 cases)according to whether they were complicated with EC or EAH.The clinical data of the patients were retrospectively analyzed,and the clinical characteristics and treatment strategies of the patients with adenomyosis complicated with endometrial cancer were discussed.Results Univariate analysis showed that age,increased proportion of CA125 and CA125,uterine volume,proportion of hypertension and abnormal endometrial ultrasonography in patients with AM with EC or EAH were significantly higher than those in the control group,and the proportion of dysmenorrhea was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that endometrial thickening,endometrial echogenicity,and endometrial thickening combined with echogenicity were independent risk factors for AM with EC or EAH.Conclusion In clinical practice,the patients with AM with endometrial thickening or uneven echo-echo of ultrasound should be treated by hysteroscopy and curettage before further operation plan is formulated,so as to achieve the purpose of early diagnosis and treatment of EC.

关 键 词：子宫腺肌病 子宫内膜癌 子宫内膜不典型增生 异常子宫出血 危险因素 术前诊断 

分 类 号：R737.33[医药卫生—肿瘤]