子宫内膜非典型增生行全子宫切除术159例临床分析

目的：探讨子宫内膜非典型增生（AEH）患者的临床特点及行全子宫切除术后病理升级为子宫内膜癌（EC）的危险因素。方法：回顾性分析2015年1月—2018年12月159例因AEH于首都医科大学附属北京妇产医院妇科微创中心行全子宫切除术患者的临床资料，按照术后病理情况分为非EC组134例（84.3%）、EC组25例（15.7%），分析其术后病理升级的高危因素。结果：与非EC组相比，EC组肥胖、绝经、异常子宫内膜血流信号及糖尿病的发生率差异具有统计学意义（均P＜0.05）。多因素Logistic回归分析结果显示，肥胖（OR=3.196，95%CI：1.147～8.902，P=0.026）及糖尿病（OR=3.866，95%CI：1.019～14.673，P=0.047）是AEH患者术后病理升级为EC的危险因素。结论：AEH患者并发EC的发生率较高，对于合并肥胖及糖尿病的患者更应引起重视，术前综合评估，制定个体化治疗方案。

Clinical Analysis of 159 Patients with Atypical Endometrial Hyperplasia Treated by Hysterectomy

Objective：This study investigated the clinical characteristics of patients diagnosed with atypical endometrial hyperplasia (AEH) and explored the risk factors of AEH upgraded to endometrial cancer (EC) after hysterectomy. Methods：159 cases of women with AEH who underwent hysterectomy during January 2015 to December 2018 in our hospital were recruited in this retrospective study. All patients were divided into two groups according to their pathological results after hysterectomy, the non-EC group (n=134, 84.3%) and the EC group (n=25, 15.7%). Results：Results showed that the incidence of obesity, menopause, abnormal blood flow signals indicated by ultrasound and diabetes were different between two groups (P＜0.05). Multivariate Logistic analysis showed that obesity (OR=3.196, 95%CI: 1.147-8.902, P=0.026) and diabetes (OR=3.866, 95%CI: 1.019-14.673, P=0.047) were independent risk factors of upgraded pathological results. Conclusions：The incidence of EC coexisted with AEH is high. For AEH patients with obesity and diabetes, comprehensive assessments and individualized treatment are needed. These high-risk patients can be overlooked until final pathology.