Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, China.
Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, China.
Reprod Biol Endocrinol. 2022 Sep 5;20(1):134. doi: 10.1186/s12958-022-01006-0.
Fertility-sparing treatment of atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EC) patients has recently emerged important social health topic. This study is designed to explore the risk factors for time to complete remission (CR) of fertility-sparing treatment in woman with AEH and early EC.
A retrospective study was designed with clinical data from 106 patients admitted between January 2012 to December 2019. Univariate and multivariate logistic analysis were used to explore independent risk factors for time to CR. These factors were employed in receiver operator characteristic (ROC) curve and the decision curve analysis (DCA) to evaluate predictive accuracy of time to CR. Stratified analysis and interactive analysis was also performed for more in-depth perspective.
Univariate analysis showed that fasting blood glucose levels (FBG, OR = 1.6, 95%CI: 0.6-2.5, P = 0.020), metabolic syndrome (MetS, OR = 3.0, 95%CI: 1.1-5.0, P = 0.003), and polycystic ovary syndrome (PCOS, OR = 2.0, 95%CI: 0.5-3.4, P = 0.009) were associated with time to CR. Among these factors, multivariate analysis confirmed MetS (OR = 3.1, 95%CI: 1.0-5.2, P = 0.005) was an independent risk factor. The area under the ROC curve (AUC) of MetS was higher than FBG and PCOS (AUC = 0.723 vs 0.612 and 0.692). The AUC of FBG combined with PCOS was 0.779, and it was improved to 0.840 when MetS was included (P < 0.05). Additionally, MetS played different roles in time to CR in various groups. Moreover, we found high-density lipoprotein (HDL) and MetS had an interactive effect for time to CR.
MetS is an independent risk factor for time to CR and should be taken seriously in fertility-sparing management of AEH and early EC patients.
保留生育功能治疗非典型子宫内膜增生（AEH）和早期子宫内膜癌（EC）患者已成为一个重要的社会健康话题。本研究旨在探讨 AEH 和早期 EC 患者保留生育功能治疗后完全缓解（CR）时间的影响因素。
设计了一项回顾性研究，纳入了 2012 年 1 月至 2019 年 12 月期间收治的 106 例患者的临床资料。采用单因素和多因素逻辑回归分析探讨 CR 时间的独立危险因素。这些因素被用于受试者工作特征（ROC）曲线和决策曲线分析（DCA），以评估 CR 时间的预测准确性。还进行了分层分析和交互分析，以进行更深入的探讨。
单因素分析显示，空腹血糖水平（FBG，OR=1.6，95%CI：0.6-2.5，P=0.020）、代谢综合征（MetS，OR=3.0，95%CI：1.1-5.0，P=0.003）和多囊卵巢综合征（PCOS，OR=2.0，95%CI：0.5-3.4，P=0.009）与 CR 时间相关。在这些因素中，多因素分析证实 MetS（OR=3.1，95%CI：1.0-5.2，P=0.005）是独立的危险因素。MetS 的 ROC 曲线下面积（AUC）高于 FBG 和 PCOS（AUC=0.723 比 0.612 和 0.692）。FBG 联合 PCOS 的 AUC 为 0.779，当纳入 MetS 时，AUC 提高至 0.840（P<0.05）。此外，MetS 在不同组别中对 CR 时间的影响不同。此外，我们发现高密度脂蛋白（HDL）和 MetS 对 CR 时间有交互作用。
MetS 是 CR 时间的独立危险因素，在 AEH 和早期 EC 患者的保留生育功能管理中应予以重视。
