Horowitz G M, Christensen S, Kennebeck C, Graham R L
Department of Obstetrics and Gynecology, University of Missouri-Columbia 65212, USA.
J Reprod Med. 2000 Jul;45(7):553-6.
To follow a population at high risk for endometrial carcinoma after endometrial ablation, to determine if ablation alters the incidence or detection of endometrial pathology.
The animal model included 33 New Zealand white rabbits. Of this cohort, 17 underwent surgical ablation of the endometrium via laparotomy, while 16 served as controls. Vaginal bleeding was assessed with monthly cotton swab examinations as well as daily observation of the subjects. All animals received unopposed estrogen for 18 months prior to necropsy.
No animal in either arm of the study demonstrated vaginal bleeding. Two rabbits from the ablation group and three controls showed histologic evidence of atypical endometrial hyperplasia or adenocarcinoma (P > .20). One additional animal from each group had hyperplasia without atypia.
This animal model suggests that endometrial ablation does not decrease the risk of endometrial carcinoma in patients at high risk of developing endometrial pathology. Detection of hyperplasia or carcinoma in such a population may prove difficult due to the absence of traditional signs of endometrial abnormalities.
追踪子宫内膜切除术后子宫内膜癌高危人群，以确定切除是否改变子宫内膜病变的发生率或检出率。
动物模型包括33只新西兰白兔。在该队列中，17只经剖腹术进行子宫内膜手术切除，16只作为对照。通过每月棉拭子检查以及对受试对象的每日观察来评估阴道出血情况。所有动物在尸检前接受18个月的单一雌激素治疗。
研究的任何一组中均无动物出现阴道出血。切除组的2只兔子和3只对照组兔子显示出非典型子宫内膜增生或腺癌的组织学证据（P>.20）。每组另有1只动物有非非典型性增生。
该动物模型表明，子宫内膜切除不会降低有发生子宫内膜病变高危风险患者患子宫内膜癌的风险。由于缺乏子宫内膜异常的传统体征，在此类人群中检测增生或癌可能很困难。
