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子宫内膜增生症患者的子宫内膜癌风险因素:对临床治疗的启示。

Risk factors of endometrial cancer in patients with endometrial hyperplasia: implication for clinical treatments.

机构信息

Department of Obstetrics and Gynecology, Fuping County Hospital, Weinan, China.

Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, No. 107 Road Yanjiang West, Guangzhou, China.

出版信息

BMC Womens Health. 2021 Aug 25;21(1):312. doi: 10.1186/s12905-021-01452-9.

Abstract

BACKGROUND

Endometrial hyperplasia (EH) is commonly-seen in the patients with endometrial cancer (EC), we aimed to evaluated the risk factors of EC in patients with EH, to provide evidence to the clinical prevention and treatment of EC.

METHODS

This study was a retrospective study design. EH patients confirmed by pathological examinations and treated with hysterectomy in our hospital from June 1, 2018 to February 28, 2021 were included. The clinical characteristics of EC and no-EC patients were compared and analyzed. Logistics regression analyses were conducted to evaluate the risk factors of EC in patients with EH.

RESULTS

A total of 228 EH patients were included, the incidence of EC in the EH patients was 31.58%. There were significant differences in the age, BMI, diabetes, hypertension and pathology of EH between EC and no EC groups (all P < 0.05), no significant differences in the hyperlipidemia, preoperative CA, number of deliveries, menopause and endometrial thickness between EC and no EC groups were found (all P > 0.05). Logistic regression analyses indicated that age > 50 y (OR 3.064, 95% CI 1.945-5.931), BMI ≥ 25 kg/m (OR 2.705, 95% CI 1.121-3.889), diabetes (OR 3.049, 95% CI 1.781-5.114), hypertension (OR 2.725, 95% CI 1.108-3.431) and severe hyperplasia (OR 3.181, 95% CI 1.496-4.228) were the risk factors of EC in patients with EH (all P < 0.05).

CONCLUSIONS

The risk of EC in EH patients is high, especially for those patients with age > 50 y, BMI ≥ 25 kg/m, diabetes, hypertension and severe hyperplasia, special attentions should be paid for occurrence of EC and early diagnosis and early treatment are needed for those patients.

摘要

背景

子宫内膜增生症(EH)在子宫内膜癌(EC)患者中较为常见,本研究旨在评估 EH 患者发生 EC 的危险因素,为 EC 的临床防治提供依据。

方法

本研究为回顾性研究设计。纳入 2018 年 6 月 1 日至 2021 年 2 月 28 日在我院因 EH 接受子宫切除术治疗的患者,比较并分析 EC 患者与非 EC 患者的临床特征。采用 Logistic 回归分析评估 EH 患者发生 EC 的危险因素。

结果

共纳入 228 例 EH 患者,EH 患者 EC 的发生率为 31.58%。EC 组与非 EC 组患者的年龄、BMI、糖尿病、高血压和病理类型比较,差异均有统计学意义(均 P<0.05);两组患者的高脂血症、术前 CA、分娩次数、绝经和子宫内膜厚度比较,差异均无统计学意义(均 P>0.05)。Logistic 回归分析结果显示,年龄>50 y(OR=3.064,95%CI:1.9455.931)、BMI≥25 kg/m(OR=2.705,95%CI:1.1213.889)、糖尿病(OR=3.049,95%CI:1.7815.114)、高血压(OR=2.725,95%CI:1.1083.431)和重度增生(OR=3.181,95%CI:1.496~4.228)是 EH 患者发生 EC 的危险因素(均 P<0.05)。

结论

EH 患者发生 EC 的风险较高,尤其对于年龄>50 y、BMI≥25 kg/m、糖尿病、高血压和重度增生的患者,应特别注意 EC 的发生,对这些患者需进行早期诊断和治疗。

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