超声检测绝经后无症状妇女子宫内膜厚度的临床价值  

Clinical Value of Ultrasound Detection of Endometrial Thickness in Asymptomatic Postmenopausal Women

作　　者：徐榕 潘建凤 陈丽珍 Xu Rong;Pan Jianfeng;Chen Lizhen(Lishui District People's Hospital,Nanjing 221200,Jiangsu Province,China;不详)

机构地区：[1]南京市溧水区人民医院,江苏省南京市211200 [2]景德镇市第一人民医院,江西省景德镇市333000

出　　处：《中国病案》2024年第7期107-111,共5页Chinese Medical Record

摘　　要：目的探讨超声检测绝经后无症状妇女子宫内膜厚度的临床价值。方法收集分析2020年1月1日-2023年6月30日期间在某院行TVS检查的女性患者850例,收集并分析患者的临床特征,包括年龄、绝经年龄、子宫内膜厚度、体重指数(kg/m^(2))、孕次、产次以及子宫内膜癌家族史;所有患者行TVS检查,超声评估子宫内膜厚度,子宫内膜回声均匀性、有无宫腔积液以及子宫内膜有无血流信号;在宫腔镜下行子宫内膜活检,并按病理诊断将正常子宫内膜、子宫内膜息肉、黏膜下肌瘤、增生性子宫内膜、子宫内膜炎、萎缩性子宫内膜等良性病变或改变纳入A组;子宫内膜癌和子宫内膜不典型增生患者被纳入B组;绘制子宫内膜厚度值,预测子宫内膜不典型增生及子宫内膜癌风险的ROC曲线。结果850例患者子宫内膜活检的病理结果分为A组患者808例(95.1%),B组患者42例(4.9%);两组患者临床特征分析显示,B组在绝经年龄、子宫内膜厚度及子宫内膜厚度分布方面对比A组均有明显差异(P<0.05);而年龄、体重指数(kg/m^(2))、孕次、产次以及子宫内膜癌家族史等方面并无差异(P>0.05)。850例患者子宫内膜厚度值绘制ROC曲线显示,AUC为0.842(95%CI:0.788–0.896),敏感度为81.0%,特异度为76.8%,最大约登指数为0.578,子宫内膜厚度≥10.5 mm患者不典型增生及子宫内膜癌的检出率显著增高(P<0.05);两组患者TVS检查显示:B组患者子宫内膜超声回声信号不均匀比例较A组明显增高(P<0.05);子宫内膜有无血流信号及有无宫腔积液对比,两组对比差异无统计学意义(P>0.05)。结论超声检测有助于为绝经后无症状子宫内膜增厚患者确定子宫内膜厚度的风险阈值,为绝经后无症状患者子宫内膜增厚的管理提供临床参考价值。Objectives This study aims to investigate the clinical value of ultrasound detection of endometrial thickness in postmenopausal asymptomatic women.Methods Medical cases of 850 female patients who underwent TVS examination in the hospital from January 1,2020 to June30,2023 were collected.Their clinical characteristics were collected and analyzed,including age,menopausal age,endometrial thickness,body mass index(kg/m^2),pregnancy and birth history,and family history of endometrial cancer.All patients underwent transvaginal ultrasound(TVS).Ultrasound evaluation included assessment of endometrial thickness,endometrial echo uniformity,presence or absence of uterine effusion,and endometrial blood flow signal.Endometrial biopsy was performed under hysteroscopy,with benign lesions or changes such as normal endometrial polyps,submucous myoma,proliferative endometrium,endometritis,and atrophic endometrium classified into group A based on pathological diagnosis.Patients with endometrial cancer or endometrial atypical hyperplasia were classified into group B.The ROC curve of endometrial thickness for predicting the risk of endometrial atypical hyperplasia and endometrial cancer was plotted.Results The pathological results of 850 patients with endometrial thickness≥5mm were divided into group A(808 cases,95.1%)and group B(42 cases,4.9%).The analysis of clinical characteristics of the two groups showed that there were significant differences in menopause age,endometrial thickness and endometrial thickness distribution in group B compared with group A(P<0.05).There were no differences in age,body mass index(kg/m^(2)),pregnancy time,birth time and family history of endometrial cancer(P>0.05).ROC curve of endometrial thickness of 850 patients showed that the AUC was 0.842(95%CI:0.788–0.896),sensitivity was 81.0%,specificity was 76.8%,maximum entry index was 0.578,and the detection rates of atypical hyperplasia and endometrial cancer in patients with endometrial thickness≥10.5 mm significantly increased(P<0.05).TVS examinati

关 键 词：经阴道超声 子宫内膜增厚 子宫内膜癌 ROC曲线 

分 类 号：R711[医药卫生—妇产科学] R445.1[医药卫生—临床医学]