细红线——子宫内膜厚度小于4mm的绝经后异常子宫出血。
The thin red line - postmenopausal abnormal uterine bleeding with endometrial thickness less than 4 mm.
作者信息
Piróg Magdalena, Kacalska-Janssen Olga, Bereza Tomasz, Jach Robert
机构信息
Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland.
出版信息
Contemp Oncol (Pozn). 2019;23(1):43-46. doi: 10.5114/wo.2019.83816. Epub 2019 Apr 5.
AIM OF THE STUDY
To evaluate the risk of endometrial malignancy in postmenopausal women with abnormal uterine bleeding (AUB) with endometrial thickness ≤ 4 mm.
MATERIAL AND METHODS
Histological assessment of endometrial samples obtained via hysteroscopy or curettage was performed in 57 women.
RESULTS
Women with premalignancy or malignancy (24.6%) had higher endometrial thickness (by 9.7%, = 0.01) compared to women with benign condition. Out of 12 women with atypical hyperplasia (21.1%), 5 women (8.8%) were diagnosed with simple and 7 women (12.3%) had complex hyperplasia, whereas 2 (3.5%) were diagnosed with malignancy.
CONCLUSIONS
Postmenopausal women with AUB and endometrial echo ≤ 4 mm are less likely to have a malignant condition. However, the role of histological evaluation cannot be undermined, especially in women at high risk of endometrial cancer, and routine endometrial biopsy should be considered. We recommend a change in the cut-off to 2 mm in routine practice.
研究目的
评估子宫内膜厚度≤4mm的绝经后异常子宫出血（AUB）女性发生子宫内膜恶性病变的风险。
材料与方法
对57名女性通过宫腔镜检查或刮宫获取的子宫内膜样本进行组织学评估。
结果
与良性病变女性相比，癌前病变或恶性病变女性（24.6%）的子宫内膜厚度更高（高9.7%，P = 0.01）。在12名非典型增生女性（21.1%）中，5名女性（8.8%）被诊断为单纯性增生，7名女性（12.3%）为复杂性增生，而2名（3.5%）被诊断为恶性病变。
结论
子宫内膜厚度≤4mm的绝经后AUB女性发生恶性病变的可能性较小。然而，组织学评估的作用不可忽视，尤其是在子宫内膜癌高危女性中，应考虑进行常规子宫内膜活检。我们建议在常规实践中将临界值改为2mm。
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