影响子宫内膜不典型增生诊断的临床因素

目的:探讨子宫内膜不典型增生(AEH)的临床特点和影响诊断的相关因素。方法:回顾性分析广西医科大学第一附属医院77例术前诊断为AEH患者的临床病理资料,根据术后病理诊断分为子宫内膜癌组(A组,50例)和AEH组(B组,27例)进行比较分析。结果:A组全部为子宫内膜样腺癌,占64.9%,B组占35.1%;两组年龄比较,t=2.708,P=0.008<0.05,差异有统计学意义;术后病理诊断与术前诊刮AEH的分度有关,轻、中、重度AEH合并子宫内膜癌率分别为28.6%、42.1%、78.4%;两组肿瘤标记物CA125比较,P=0.140>0.05,差异无统计学意义。结论:①年龄是AEH合并子宫内膜癌的高危因素;②随着诊刮AEH分度增加,合并子宫内膜癌有增加趋势;合并子宫内膜癌多数分化较好、浸润少、期别以Ⅰ期为主。③血清CA125不是预测AEH合并子宫内膜癌的敏感指标。

Clinical influencing factors of diagnosis of atypical endometrial hyperplasia

Objective:To explore the clinical characteristics of atypical endometrial hyperplasia(AEH) and the related influencing factors.Methods:The clinicopathological data of seventy-seven patients diagnosed as AEH in the hospital preoperatively were analyzed retrospectively,then they were divided into two groups according to postoperative pathological diagnosis: endometrial cancer group(group A,50 cases) and AEH group(group B,27 cases),the results in the two groups were compared.Results:The cases in group A were diagnosed as endometrioid adenocarcinoma,which accounted for 64.9%,and the cases with endometrioid adenocarcinoma in group B accounted for 35.1%.There was statistically significant difference in age between the two groups(t=2.708,P=0.008).The postoperative pathological diagnosis was associated with preoperative degree of AEH after uterine curettage: the coexistence rates of endometrial carcinoma with AEH of slight,moderate,and high degrees were 28.6%,42.1%,and 78.4%,respectively.There was no statistically significant difference in the concentration of tumor marker(CA125) between the two groups(P>0.05).Conclusion:Age is a high risk factor for coexistence with endometrial carcinoma.With the progression of AEH degree,the trend of coexistence with endometrial carcinoma enhances.The coexistent with endometrial carcinoma is mostly staged in FIGOⅠ with high differentiation and less infiltration.Serum CA125 is not a sensitive index for indicating AEH coexisting with endometrial carcinoma.