本文選題：子宮內(nèi)膜不典型增生　切入點(diǎn)：子宮內(nèi)膜癌　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:研究子宮內(nèi)膜不典型增生的臨床特征及合并子宮內(nèi)膜癌的風(fēng)險(xiǎn)預(yù)測(cè)。方法:收集2007年1月至2017年1月因術(shù)前子宮內(nèi)膜病理提示子宮內(nèi)膜不典型增生而行全子宮切除術(shù)的171例患者的臨床資料。根據(jù)全子宮切除術(shù)術(shù)后病理結(jié)果分為子宮內(nèi)膜不典型增生(AEH)組(117例)和子宮內(nèi)膜癌(EC)組(54例),回顧性比較兩組的臨床特征,同時(shí)用logistic回歸對(duì)合并子宮內(nèi)膜癌的風(fēng)險(xiǎn)進(jìn)行預(yù)測(cè)。結(jié)果:1.單因素結(jié)果顯示:子宮內(nèi)膜不典型增生組在年齡、絕經(jīng)狀態(tài)、病理與子宮內(nèi)膜癌組對(duì)比,差異有統(tǒng)計(jì)學(xué)意義(P0.05),而在高血壓、糖尿病、血清CA125、血清CA199、內(nèi)膜取樣至全子宮切除手術(shù)日的平均時(shí)間間隔、分娩次數(shù)、內(nèi)膜取樣方法、術(shù)前陰道超聲或MRI測(cè)定子宮內(nèi)膜平均厚度、體重質(zhì)量指數(shù)(BMI),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.多因素結(jié)果顯示:年齡≥51.5歲(OR=3.12,95%CI:1.59-6.14,P0.05)、已絕經(jīng)(OR=3.39,95%CI:1.66-6.95,P0.05)、重度AEH(OR=4.46,95%CI:2.47-8.05,P0.05)是子宮內(nèi)膜不典型增生合并子宮內(nèi)膜癌的高危因素。3.子宮內(nèi)膜不典型增生在不伴任何高危因素、伴1個(gè)高危因素、伴2個(gè)高危因素、伴3個(gè)高危因素上合并子宮內(nèi)膜癌的患者占11.94%(8/67)、35.71%(20/56)、36.36%(8/22)、69.23%(18/26),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.54例子宮內(nèi)膜不典型增生合并子宮內(nèi)膜癌患者占31.58%(54/171),有88.89%(48/54)為子宮內(nèi)膜樣腺癌I期,其中高分化占70.37%(38/54)。結(jié)論:1.子宮內(nèi)膜不典型增生合并子宮內(nèi)膜癌有較高的發(fā)生率,當(dāng)臨床上發(fā)現(xiàn)有異常陰道流血的患者,如果年齡≥51.5歲或已絕經(jīng)或診刮病理為重度子宮內(nèi)膜不典型增生時(shí)發(fā)生子宮內(nèi)膜癌的風(fēng)險(xiǎn)增加,要給予積極處理。2.子宮內(nèi)膜不典型增生合并子宮內(nèi)膜癌多為分化較好的I期子宮內(nèi)膜樣腺癌。
[Abstract]:Objective: to study the clinical features of endometrial atypical hyperplasia and the risk prediction of endometrial carcinoma. Methods: from January 2007 to January 2017, the clinical features of endometrial atypical hyperplasia were studied. The clinical data of 171 patients undergoing hysterectomy. According to the pathological results of total hysterectomy, they were divided into two groups: the endometrial atypical hyperplasia (AEH) group (n = 117) and the endometrial carcinoma (EC) group (n = 54). The clinical features of the two groups were compared retrospectively. At the same time, logistic regression was used to predict the risk of endometrial carcinoma. Results: the univariate results showed that the age, menopausal status, pathology of endometrial atypical hyperplasia group were compared with that of endometrial carcinoma group. The difference was statistically significant (P 0.05), while in hypertension, diabetes, serum CA125, serum CA199, the average interval between endometrial sampling and total hysterectomy, the number of deliveries, the method of endometrial sampling, the mean thickness of endometrium was measured by preoperative vaginal ultrasound or MRI. There was no significant difference in body mass index (BMI) (P 0.05). The multivariate results showed that the age 鈮，

本文編號(hào)：1570932