CAJ | 학술논문

目的探讨术前诊断为子宫内膜非典型增生(endometrial atypical hyperplasia,EAH)的患者并存隐匿性子宫内膜癌的风险.方法回顾性分析61例入院诊断为EAH患者的临床资料,对绝经前患者(44例)及绝经患者(17例)分别讨论.根据术后病理切片检查结果,将所有患者分为EAH组及子宫内膜癌组,分别观察绝经前患者及绝经后患者中对合并隐匿性子宫内膜癌有预测价值的危险因素,运用logistic回归分析,建立logistic回归方程,用于评估入院诊断为EAH的患者实际患子宫内膜癌的风险.结果在绝经前患者中,诊刮前子宫内膜厚度、术前EAH分级被选入方程,所建立logistic回归方程经检验有显著统计学意义(P＜0.001),其判别正确率为86.4％.在绝经患者中,绝经年限、术前EAH分度被选入方程,所建方程经检验有统计学意义(P＜0.04),其判别正确性为82.4％.结论 ①对于绝经前EAH患者,诊刮前子宫内膜厚度、EAH分度有助于临床工作中术前判断其患子宫内膜癌的风险;②对于绝经患者,绝经年限、EAH分度对术前判断其实际患子宫内膜癌的风险有应用价值,从而指导治疗方式的选择.
목적 탐토술전진단위자궁내막비전형증생(endometrial atypical hyperplasia,EAH)적환자병존은닉성자궁내막암적풍험.방법 회고성분석61례입원진단위EAH환자적림상자료,대절경전환자(44례)급절경환자(17례)분별토론.근거술후병리절편검사결과,장소유환자분위EAH조급자궁내막암조,분별관찰절경전환자급절경후환자중대합병은닉성자궁내막암유예측개치적위험인소,운용logistic회귀분석,건립logistic회귀방정,용우평고입원진단위EAH적환자실제환자궁내막암적풍험.결과 재절경전환자중,진괄전자궁내막후도、술전EAH분급피선입방정,소건립logistic회귀방정경검험유현저통계학의의(P＜0.001),기판별정학솔위86.4％.재절경환자중,절경년한、술전EAH분도피선입방정,소건방정경검험유통계학의의(P＜0.04),기판별정학성위82.4％.결론 ①대우절경전EAH환자,진괄전자궁내막후도、EAH분도유조우림상공작중술전판단기환자궁내막암적풍험;②대우절경환자,절경년한、EAH분도대술전판단기실제환자궁내막암적풍험유응용개치,종이지도치료방식적선택.
Objective To examine the frequency of coexisting endometrial carcinoma with preoperative diagnosis of endometrial atypical hyperplasia (EAH).Methods From Apr 2002 to Apr 2007,61 consecutive patients diagnosed as EAH who underwent total hysterectomy in our department were retrospectively analyzed.Patients were stratified as 44 premenopausal cases and 17 menopausal cases.The patients were divided into 2 groups depending on whether or not cancer cells were found by histology in removed uterus (cancer group vs EAH group) to explore valuable predictive risk factors for concomitant endometrial carcinoma through reviewing the clinical data.Logistic regression analysis and logistic regression equation are used to evaluate the risk of coexisting endometrial carcinoma with preoperative diagnosis of endometrial atypical hyperplasia.Results Endometrial thickness and the type of EAH were selected into the equation in premenopausal cases,showing statistically significant differences(P ＜ 0.001) and the overall accuracy was 86.4％.Menopausal years and the type of EAH were selected into the equation in menopausal women,also showing statistically significant differences (P ＜ 0.04)and the overall accuracy was 82.4％.Conclusions Endometrial thickness and the type of EAH are valuable in predicting the risk of endometrial carcinoma in premenopausal women.Menopausal years and the type of EIN are valuable in prediciting the risk of coexistance with endometrial carcinoma in menopausal women.