Menzies Rebecca, Wallace Sarah, Ennis Marguerite, Bennett Alison, Jacobson Michelle, Yip Gina, Wolfman Wendy
Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
J Obstet Gynaecol Can. 2011 Sep;33(9):944-51. doi: 10.1016/s1701-2163(16)35020-4.
We sought to determine the incidence of cancer and to compare pathologic outcomes in bleeding and non-bleeding postmenopausal patients who underwent hysteroscopy.
We conducted a retrospective chart review of 294 postmenopausal women with abnormal uterine bleeding and 142 postmenopausal women without symptoms who underwent hysteroscopy. An 11 mm cut-off for asymptomatic women was applied to determine whether this endometrial thickness threshold would differentiate women with and without endometrial cancer in the asymptomatic group.
In symptomatic patients, 14 were found to have endometrial cancer and 10 were found to have endometrial hyperplasia. In the asymptomatic group, two women (1.4%) were found to have endometrial cancer with average thickness 17.5 mm, and one (0.71%) was found to have endometrial hyperplasia. Logistic regression models showed the risk of a bleeding patient developing endometrial cancer at an endometrial thickness of 4 mm was the same as the risk in a non-bleeding patient at a thickness of 15 mm.
Asymptomatic postmenopausal women have a low risk of having significant endometrial pathology. Cancer was approximately four times more prevalent in women with bleeding than in women with no bleeding.
我们试图确定癌症的发病率，并比较接受宫腔镜检查的绝经后出血和未出血患者的病理结果。
我们对294例绝经后子宫异常出血的女性和142例无症状的绝经后接受宫腔镜检查的女性进行了回顾性病历审查。对无症状女性采用11毫米的临界值来确定该子宫内膜厚度阈值是否能区分无症状组中有和没有子宫内膜癌的女性。
在有症状的患者中，发现14例患有子宫内膜癌，10例患有子宫内膜增生。在无症状组中，两名女性（1.4%）被发现患有子宫内膜癌，平均厚度为17.5毫米，一名（0.71%）被发现患有子宫内膜增生。逻辑回归模型显示，出血患者在子宫内膜厚度为4毫米时发生子宫内膜癌的风险与非出血患者在厚度为15毫米时的风险相同。
无症状绝经后女性发生严重子宫内膜病变的风险较低。出血女性患癌症的几率大约是未出血女性的四倍。
