肥胖、糖尿病和高血压与子宫内膜癌前病变和癌的相关性分析

目的]分析绝经前妇女子宫内膜发生恶变的相关危险因素。方法]回顾性分析630例因阴道出血就诊并经病理证实绝经前子宫内膜病变患者的临床资料，比较分析良性病变组（595例）和恶性病变组（35例）患者的临床特征以及子宫内膜恶变的相关危险因素。恶性病变相关高危因素分析采用Logistic多元回归分析。结果]调整年龄、子宫内膜厚度因素后，肥胖（RK=2．938，95％CI：1．060～8．142）、糖尿病（RR=9．945，95％CI：3．297—29．997）患子宫内膜癌前病变，癌恶性病变的风险增加。且有统计学差异：高血压患子宫内膜癌前病变／癌恶性病变的风险是无高血压患者的1．752倍（95％CI：0．903～7．831），无统计学差异。结论]肥胖、糖尿病与子宫内膜癌密切相关。因此，若能尽早改变生活方式，如合理饮食、增加活动量则有可能在很大程度上预防子宫内膜癌的发生。

Correlation Between Obesity,Diabetes and Hypertension As- sociated with Endometrial Cancer and Precancerous Lesions

Purpose ] To investigate the risk factors related to endometrial malignancy in pre- menopausal women. Methods] The clinical data of 630 vaginal bleeding premenopausal patients with endometrial lesions pathological proven were retrospectively analyzed. The clinical features in benign lesions group（595 cases） and malignant lesions group（35 cases） were compared, and risk factors associated with endometrial malignancy were analyzed with Logistic regression analysis. Results] After adjusting age and endometrial thickness,obesity（RR=2.938,95%CI： 1.060N8.142）, diabetes （RR = 9.945,95 % CI ： 3.297 ～ 29.997） increased the risk of endometrial precancerous lesions/cancer. The risk ratio of endometrial malignant lesions in patients with hypertension was 1.752 （95%CI：0.903N7.831）,without significant difference. Conclusions3 Obesity,diabetes close- ly relate to endometrial cancer. Therefore,if lifestyle changes as soon as possible,such as proper diet, increasing activity levels ,there are likely to prevent endometrial cancer a large extent.