Feldman S, Cook E F, Harlow B L, Berkowitz R S
Department of Obstetrics, Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Gynecol Oncol. 1995 Mar;56(3):376-81. doi: 10.1006/gyno.1995.1066.
We studied 203 women ages 49 or over who presented with abnormal vaginal bleeding and who underwent either endometrial biopsy or dilation and curettage at the Brigham and Women's Hospital. Using information from the clinical history, we predicted their risk for endometrial cancer (36 patients) or complex endometrial hyperplasia (16 patients). Factors independently associated with endometrial cancer/complex hyperplasia included age 70 or older (OR = 9.1, P = 0.0001), diabetes (OR = 3.7, P = 0.02), and nulliparity (OR = 2.7, P = 0.02). After adjusting for age, menopause was borderline significant (OR = 2.6, P = 0.07). Our data estimated a risk of endometrial cancer/complex hyperplasia of 87% for a woman possessing all of these factors, and a risk of less than 3% if she had none of them. Our model provides an inexpensive, simple means for assessing the risk of endometrial cancer and complex hyperplasia in the post- or perimenopausal woman with abnormal bleeding.
我们研究了203名年龄在49岁及以上、出现阴道异常出血且在布莱根妇女医院接受子宫内膜活检或刮宫术的女性。利用临床病史信息，我们预测了她们患子宫内膜癌（36例患者）或复杂性子宫内膜增生（16例患者）的风险。与子宫内膜癌/复杂性增生独立相关的因素包括70岁及以上（比值比=9.1，P=0.0001）、糖尿病（比值比=3.7，P=0.02）和未生育（比值比=2.7，P=0.02）。在对年龄进行校正后，绝经具有临界显著性（比值比=2.6，P=0.07）。我们的数据估计，具有所有这些因素的女性患子宫内膜癌/复杂性增生的风险为87%，而没有这些因素的女性风险低于3%。我们的模型为评估绝经后或围绝经期异常出血女性患子宫内膜癌和复杂性增生的风险提供了一种廉价、简单的方法。
