超声子宫内膜厚度测量可预测单纯性无 atypia 的子宫内膜增生的治疗反应。 （备注：这里的“atypia”常见释义为“异型性” ，医学术语中可根据具体语境准确理解其含义，此处直接保留英文以便读者结合专业知识判断其确切所指。）
Ultrasonographic endometrial thickness measurement is predictive for treatment response in simple endometrial hyperplasia without atypia.
作者信息
Ozkaya Enis, Korkmaz Vakkas, Ozkaya Yeşim, Tosun Alptekin, Küçükozkan Tuncay, Bostan Hüsne
机构信息
Department of Obstetrics and Gynecology, School of Medicine, Giresun University, Giresun, Turkey.
Department of Obstetrics & Gynecology, Dr.Sami Ulus Maternity and Children's Health Teaching and Research Hospital, Ankara, Turkey.
出版信息
J Turk Ger Gynecol Assoc. 2013 Mar 1;14(1):19-22. doi: 10.5152/jtgga.2013.05. eCollection 2013.
OBJECTIVE
We sought to determine the predictors of treatment response in simple endometrial hyperplasia without atypia.
MATERIAL AND METHODS
We prospectively treated 67 women with simple endometrial hyperplasia without atypia who were administered cyclic oral medroxyprogesterone acetate 10 mg/day for 12 days of luteal phase for 3 months and underwent control endometrial sampling after treatment. All subjects were evaluated in terms of age, gravidity, parity, body mass index (BMI), menstrual cycle, endometrial thickness, uterine fibroids, ovarian cysts, serum CA 125 levels, systemic disorders and cigarette smoking. All parameters were used to predict treatment success.
RESULTS
Persistent hyperplasia was observed in 11 subjects. Endometrial thickness was significantly correlated with treatment failure (r=0.293, p=0.015). In ROC analysis, endometrial thickness was found to be predictive for persistent hyperplasia (area under curve: 0.724, P=0.019). Optimal cut off value was calculated to be 16.5 mm with 64% sensitivity, 72% specificity and 91% negative predictive value. The number of persistent hyperplasia in women with and without endometrial thickness greater than 16.5 mm was significantly different (7/23 vs. 4/45, p=0.029). Odds ratio of endometrial thickness higher than 16.5 mm for treatment failure was 4.4 (95% CI, 1.2-17.4, p=0.03).
CONCLUSION
Results of this study suggest treatment modification according to the baseline endometrial thickness in patients with simple endometrial hyperplasia without atypia.
目的
我们试图确定单纯性无 atypia 的子宫内膜增生症治疗反应的预测因素。
材料与方法
我们前瞻性地治疗了 67 例单纯性无 atypia 的子宫内膜增生症女性患者，她们在黄体期每天口服 10mg 醋酸甲羟孕酮，共 12 天，持续 3 个月，并在治疗后进行子宫内膜取样对照。所有受试者均根据年龄、妊娠次数、产次、体重指数（BMI）、月经周期、子宫内膜厚度、子宫肌瘤、卵巢囊肿、血清 CA125 水平、全身性疾病和吸烟情况进行评估。所有参数均用于预测治疗成功与否。
结果
11 名受试者出现持续性增生。子宫内膜厚度与治疗失败显著相关（r = 0.293，p = 0.015）。在 ROC 分析中，发现子宫内膜厚度可预测持续性增生（曲线下面积：0.724，P = 0.019）。计算得出最佳截断值为 16.5mm，敏感性为 64%，特异性为 72%，阴性预测值为 91%。子宫内膜厚度大于 16.5mm 和小于 16.5mm 的女性中持续性增生的数量有显著差异（7/23 对 4/45，p = 0.029）。子宫内膜厚度高于 16.5mm 导致治疗失败的优势比为 4.4（95%CI，1.2 - 17.4，p = 0.03）。
结论
本研究结果表明，对于单纯性无 atypia 的子宫内膜增生症患者，应根据基线子宫内膜厚度调整治疗方案。
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