摘要
目的:探讨绝经后无症状子宫内膜增厚女性B超所测的子宫内膜厚度、宫腔镜检查术中所见的结果及病理组织学检查结果三者之间的相关性。方法:收集绝经后超声提示子宫内膜厚度≥0.50 cm且无任何临床症状(阴道流血、流液、白带增多、腹痛、腹胀和发现盆腔包块等)的287例女性资料,分析其子宫内膜厚度、宫腔镜检查术中所见的结果及术后病理组织学检查结果,并探讨三者之间的相关性。结果:84.3%的绝经后子宫内膜增厚无症状的妇女有宫腔内病变。子宫内膜厚度为0.50~1.00 cm的患者中,子宫内膜癌癌前病变检出率1.7%,宫颈腺癌检出率0.7%。子宫内膜厚度>1.00~1.50 cm患者中,恶性肿瘤(子宫内膜癌、宫颈腺癌)检出率2.1%。子宫内膜厚度>1.50 cm的患者中,均有宫腔内病变,无阴性结果,子宫内膜癌检出率1.4%,子宫内膜癌前病变检出率0.3%;子宫内膜厚度>2.00 cm的2例患者病理组织检查均为子宫内膜腺癌。子宫内膜厚度在宫腔内病变(无论良性、恶性)中的预测最佳阈值为0.65 cm,敏感度为81.1%,特异度为28.5%。结论:绝经后无症状子宫内膜增厚的女性(内膜厚度>0.65 cm),其宫腔良、恶性疾病的患病率高,须引起重视,且常规超声随访仍是比较安全可靠的方法,必要时须行宫腔镜检查及病理组织学检查以排除恶性病变。当患者子宫内膜厚度0.50~0.65 cm,暂可排除宫内恶性病变,可予患者短期随访,若随访过程中出现内膜厚度无变薄或持续性增厚等,有行宫腔镜检查的指征。
Objective:To determine the correlation among endometrial thickness,hysteroscopic findings and pathological findings in asymptomatic postmenopausal women with endometrial thickening.Methods:287 postmenopausal women with endometrial thickness more than or equal to 0.5 cm and without any clinical symptoms(vaginal bleeding,fluid flow,leucorrhea increase,abdominal pain and abdominal distention,pelvic mass,etc.)were analyzed retrospectively.The correlation of endometrial thickness,hysteroscopic examination and postoperative pathological examination results was analyzed.Results:84.3%of postmenopausal women with asymptomatic endometrial thickening had intrauterine lesions.In patients with endometrial thickness of 0.50-1.00 cm,among which the detection rate of endometrial precancerous lesions was 1.7%,and the detection rate of cervical adenocarcinoma was 0.7%.In patients with endometrial thickness of>1.00-1.50 cm,the detection rate of malignant tumors(endometrial cancer,cervical adenocarcinoma)was 2.1%.In the patients with endometrial thickness greater than 1.50 cm,there were intrauterine lesions without negative results.The detection rate of endometrial cancer was 1.4%,and the detection rate of precancerous lesions was 0.3%.Two patients with endometrial thickness more than 2.00 cm were diagnosed as endometrial adenocarcinoma by pathological examination.The best prediction threshold of endometrial thickness in intrauterine lesions(benign and malignant)was 0.65 cm,the sensitivity was 81.1%,and the specificity was 28.5%.Conclusion:Asymptomatic women with postmenopausal endometrial thickening(endometrial thickness>0.65 cm)have a high incidence of uterine benign and malignant diseases,to which attention needs to be paid.Conventional ultrasound follow-up is still a safe and reliable method.If necessary,hysteroscopy and pathological examination should be performed to exclude malignant diseases.When the endometrial thickness of the patient is between 0.50-0.65 cm,the intrauterine malignant lesions can be temporarily excluded,and the patient can be given short-term follow-up.If the endometrial thickness has no thinning or persistent thickening during the follow-up,there is an indication for hysteroscopy.
作者
刘艳佳
孟炜
何艳
全丽娟
LIU Yanjia;MENG Wei;HE Yan;QUAN Lijuan(Gynecology Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;School of Health Management,Xinjiang Medical University,Urumqi 830054,China)
出处
《东南大学学报（医学版）》
CAS
2023年第4期602-606,共5页
Journal of Southeast University(Medical Science Edition)
基金
新疆维吾尔自治区自然科学基金资助项目(2016D01C283)。
关键词
绝经后无症状子宫内膜增厚
宫腔镜检查
病理组织学检查
postmenopausal asymptomatic endometrial thickening
hysteroscopy
histopathologic examination
