绝经后子宫内膜增厚的临床与病理分析

目的:探讨绝经后子宫内膜增厚的影响因素,并进行病理类型分析。方法:分析190例绝经后经B超检查子宫内膜厚度大于4 mm,并行诊断性刮宫及(或)子宫切除妇女的临床和病理资料。结果:①190例患者中,应用激素替代治疗(hormone rep lacem ent therapy,HRT)者68例占35.8%,高血压者37例占19.5%,应用他莫西酚者15例占7.9%。此3项是影响子宫内膜增厚的主要因素,其他因素有吸烟、不育、糖尿病;②子宫内膜厚度4 mm者48例,以萎缩性子宫内膜表现为主,未见有子宫内膜癌的发生;子宫内膜厚度57 mm者62例,以内膜增生、内膜增殖症为主,不典型增生2例,内膜癌6例;子宫内膜厚度89 mm者42例,其中内膜癌11例,非典型增生4例;子宫内膜厚度≥10 mm者38例,其中内膜癌15例,不典型增生6例,内膜癌的发病率明显增高。结论:子宫内膜癌与子宫内膜的增厚有密切相关性。绝经后子宫内膜厚度>4 mm者应行诊断性刮宫。

Analysis on the clinical observation and pathologic type about endometrial thickness in postmenopausal

Objective:To investigate factors associated with endometrial thickness and pathologic type in postmenopausal women.Methods:190 postmenopausal women whose endometrial was thicker than 4 mm were examined by sonography.All of them were underwent curettage and /or hysterectomy and pathological examination.Results:①68 of 190(35.8%)postmenopsal women took HRT,37 of the 190 women(19.5%)had hypertension,and 15 women(7.9%)took Tamoxifen drugs.The most important factors associated with endometrial thickness were the above three factors.Other factors were smoking、infertility and diabetes mellitus;②The most common pathologic type of 48 women whose endometrial thickness were 4 mm was hyperplasia.No cancer was found in this group.The most common pathologic type of 62 women whose endometrial thickness were 5~7mm was also hyperplasia,and six endometrial cancer were found in this group.Eleven endometrial cancer and four atypical hyperplasia cases were found in 42 women whose endometrial thickness were 8~9mm.Fifteen endometrial cancer and six atypical hyperplasia cases were found in 38 women whose endometrial thickness were≥10 mm.The incidence rate of endometrial cancer in this group was greatly higher than other groups.Conclusion:One of the risk factors for endometrial cancer is shown to be endometrial thickness.Women with an endometrial thickness>4 mm should do curettage or endometrial biopsy.