子宫内膜复杂非典型增生孕激素治疗效果影响因素分析  

Influencing Factors of Progesterone Treatment Effecton Complex Atypical Hyperplasia of Endometrium

作　　者：章亮 王冰[2] ZHANG Liang;WANG Bing(Department of Pathology,Second People’s Hospital of Fuyang District,Hangzhou,Zhejiang 311404,China;Pathology Department of Tongde Hospital,Hangzhou,Zhejiang 310012,China)

机构地区：[1]杭州市富阳区第二人民医院病理科,浙江杭州311404 [2]浙江省立同德医院病理科,浙江杭州310012

出　　处：《河北北方学院学报（自然科学版）》2024年第12期8-12,共5页Journal of Hebei North University:Natural Science Edition

摘　　要：目的根据对子宫内膜复杂非典型增生患者孕激素治疗后病理评估结果及相关因素分析,探讨影响患者疗效的影响因素。方法回顾性分析经孕激素治疗6个月的50例子宫内膜复杂非典型增生患者的临床资料,根据患者治疗后子宫内膜病理组织学检查结果将其分为完全有效组、部分有效组及无效组,比较3组患者临床基线资料及子宫内膜雌、孕激素受体水平,采用有序多因素Logistic回归模型对影响疗效的因素进行分析;观察随访1年内复发或进展情况,并根据随访结果采用Kaplan-Meier法绘制时间-累积复发率曲线,应用Log rankχ^(2)检验比较患者累积复发率。结果50例患者经孕激素治疗后有42例完全有效,6例部分有效,2例无效。无效组患者初潮年龄明显高于完全有效组及部分有效组,而孕激素受体水平及有妊娠史患者的比例明显低于其余2组(均P<0.05);有序多因素Logistic分析示孕激素受体水平升高是治疗有效的保护因素,而无妊娠史则为其危险因素(均P<0.05);完全有效组累积复发率明显低于部分有效组及无效组(Log rankχ^(2)=32.177,13.915;均P<0.05);部分有效组累积复发率明显低于无效组(Log rankχ^(2)=6.983,P=0.008)。结论月经初潮时间、孕激素受体水平及妊娠情况是影响子宫内膜复杂非典型增生患者疗效的独立影响因素。Objective According to the analysis of pathological evaluation results and related factors after progesterone treatment in patients with complex atypical hyperplasia of endometrium,the factors influencing efficacy were discussed.Methods The clinical data of 50 patients with complex atypical hyperplasia of endometrium treated with progesterone for 6 months were retrospectively analyzed.According to the results of endometrial histopathological examination after treatment,the patients were divided into completely effective group,partially effective group and ineffective group.The clinical baseline data and endometrial estrogen and progesterone receptor levels of the three groups were compared.The factors affecting efficacy were analyzed by ordinal multivariate Logistic regression model.The recurrence or progression within one year of follow-up was observed,and the time-cumulative recurrence rate curve was drawn by Kaplan-Meier method according to the follow-up results.Log rankχ^(2) test was used to compare the cumulative recurrence rate of patients.Results Among the 50 patients treated with progesterone,42 cases were completely effective,six partially effective,and two ineffective.The age of menarche in the ineffective group was significantly higher than that in the completely effective group and the partially effective group,while the level of progesterone receptor and the proportion of patients with pregnancy history were significantly lower than those in the other two groups(P<0.05).Ordinal multivariate Logistic analysis showed that elevated progesterone receptor level was a protective factor for effective treatment,while no pregnancy history was a risk factor(P<0.05).The cumulative recurrence rate of the completely effective group was significantly lower than that of the partially effective group and the ineffective group(Log rankχ^(2)=32.177,13.915;P<0.05);the cumulative recurrence rate of the partial effective group was significantly lower than that of the ineffective group(Log rankχ^(2)=6.983,P=0.008).Conc

关 键 词：子宫内膜复杂非典型增生 孕激素 病理评估 累积复发率 

分 类 号：R737.33[医药卫生—肿瘤]