Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA.
Am J Obstet Gynecol. 2012 Nov;207(5):379.e1-6. doi: 10.1016/j.ajog.2012.08.018. Epub 2012 Aug 16.
We sought to estimate cytologically benign endometrial cell (CBEC)-associated endometrial hyperplasia and cancer rates, and describe clinical and histologic outcomes.
Medical records of women age >40 years with CBEC in 2005 through 2010 were reviewed for clinical characteristics; assessment with endometrial biopsy, ultrasound, or hysteroscopy; and consequent outcomes.
Of 658 women, 281 (42.7%) were assessed: 39.4% of 330 premenopausal, and 46.0% of 328 postmenopausal women. Among these, cancer rate was 3.6% and differed between premenopausal (0.8%) and postmenopausal (6.0%) women (P = .019). Hyperplasia rate was similar in premenopausal (3.9%) and postmenopausal (3.3%) women. Of 20 assessed women with endometrial pathology, 4 (1 premenopausal) women with cancer and 4 (2 premenopausal) women with hyperplasia had no abnormal bleeding.
Cancer was more common in postmenopausal women with assessed CBEC while hyperplasia was comparably distributed between premenopausal and postmenopausal women. Findings support CBEC assessment regardless of menopausal status or abnormal bleeding.
我们旨在评估细胞学良性子宫内膜细胞(CBEC)相关的子宫内膜增生和癌症发生率,并描述临床和组织学结果。
回顾了 2005 年至 2010 年期间年龄>40 岁的 CBEC 患者的病历,以了解其临床特征;进行子宫内膜活检、超声或宫腔镜评估;以及随后的结果。
在 658 名女性中,有 281 名(42.7%)接受了评估:330 名绝经前女性中 39.4%,328 名绝经后女性中 46.0%。其中,癌症发生率为 3.6%,绝经前(0.8%)和绝经后(6.0%)女性之间存在差异(P =.019)。增生发生率在绝经前(3.9%)和绝经后(3.3%)女性中相似。在 20 名接受子宫内膜病理检查的女性中,有 4 名(1 名绝经前)患有癌症,4 名(2 名绝经前)患有增生的女性没有异常出血。
在接受评估的 CBEC 绝经后女性中,癌症更为常见,而增生在绝经前和绝经后女性中的分布相似。这些发现支持无论绝经状态或异常出血情况如何,都应进行 CBEC 评估。