Department of Gynecology, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, 830011, China.
Department of Obstetrics and Gynecology, Dongfang Hospital of Tongji University, No. 1800 Yuntai Road, Pudong New District, Shanghai, 200000, China.
Arch Gynecol Obstet. 2022 Dec;306(6):2047-2054. doi: 10.1007/s00404-022-06734-7. Epub 2022 Aug 25.
The study aims to investigate the relationship between endometrial thickening and endometrial lesions in postmenopausal women.
Totally 390 postmenopausal patients with endometrial thickening ≥ 5 mm were enrolled from June 2016 to April 2020, among whom 188 patients were asymptomatic and 202 patients were symptomatic.
There were 50 cases with endometrial cancer and precancerous lesions and 150 cases with benign lesions in the symptomatic group, significantly higher than that in the asymptomatic group. The most common pathological type in the asymptomatic group was endometrial polyp. In the asymptomatic group, statistically significant differences were found in endometrial thickness between patients with endometrial cancer and precancerous lesion (group B) and those with benign lesions and non-organic lesions (group A). Statistically significant differences were also found in age, endometrial thickness, hypertension, full-term delivery time and miscarriage times between group A and group B. Regression analysis indicated that hypertension and endometrial thickness were independent risk factors for endometrial cancer and precancerous lesions in the symptomatic group. ROC analysis showed that 10.5 mm was the optimal threshold for predicting endometrial cancer and precancerous lesions in the asymptomatic group, with sensitivity of 100% and specificity of 78.3%.
The incidence of endometrial cancer and precancerous lesions in postmenopausal women with endometrial thickening and vaginal bleeding is higher than that of asymptomatic women. The endometrial thickening in postmenopausal asymptomatic women is mainly benign, and the threshold for predicting endometrial cancer and precancerous lesions is 10.5 mm.
本研究旨在探讨绝经后妇女子宫内膜增厚与子宫内膜病变的关系。
2016 年 6 月至 2020 年 4 月，共纳入 390 例子宫内膜增厚≥5mm 的绝经后患者，其中 188 例无症状，202 例有症状。
有症状组中子宫内膜癌及癌前病变 50 例，良性病变 150 例，明显高于无症状组。无症状组最常见的病理类型为子宫内膜息肉。在无症状组中，子宫内膜癌及癌前病变组（B 组）与良性病变和非器质性病变组（A 组）的子宫内膜厚度比较，差异有统计学意义。A 组与 B 组在年龄、子宫内膜厚度、高血压、足月分娩时间、流产次数方面比较，差异有统计学意义。回归分析表明，高血压和子宫内膜厚度是有症状组子宫内膜癌及癌前病变的独立危险因素。ROC 分析显示，10.5mm 是预测无症状组子宫内膜癌及癌前病变的最佳阈值，其敏感性为 100%，特异性为 78.3%。
绝经后子宫内膜增厚伴阴道出血患者子宫内膜癌及癌前病变的发生率高于无症状患者。绝经后无症状妇女的子宫内膜增厚主要为良性，预测子宫内膜癌及癌前病变的阈值为 10.5mm。
