Clinical Study Of Endometrial Hyperplasia And Carcinoma In Young Women

Objective: By investigating the clinical features,bleeding patterns,hysteroscopic features,and risk factors of endometrial hyperplasia in young women,the study aims to provide the basis of identifying high-risk patients in early stages,early diagnosis and treatment,blocking disease progression,improving prognosis,and preventing the disease.Method: During the period of 2017.1.1-2018.2.28,80 patients under 40 years of age who were diagnosed as endometrial hyperplasia or carcinoma through hysteroscopy and/or curettage in our hospital were the experimental group.138 patients that were diagnosed without endometrial hyperplasia pathologically were the control group.The chief complaints,age,gravidity and parity history,height,weight,comorbidity,family history of cancer,existance of abnormal uterine bleeding,abnormal uterine bleeding patterns,and hysteroscopy accuracy were compared between the two groups.139 patients with abnormal uterine bleeding were divided into two groups according to the presence or absence of endometrial hyperplasia,and the differences in abnormal uterine bleeding patterns between groups were compared.The 213 patients who underwent hysteroscopy were divided into two groups according to the presence or absence of endometrial hyperplasia,in order to compare the sensitivity,specificity,positive predictive value and negative predictive value of diagnosing endometrial proliferative diseases by hysteroscopy.Results:1.In the 138 patients without endometrial hyperplasia or carcinoma,34(24.6%)visited for symptoms of abnormal uterine bleeding.In the 80 patients with endometrial hyperplasia or carcinoma,68(85.0%)visited for symptoms of abnormal uterine bleeding.There was a significant difference in cheif complaints between the two groups(P<0.001).2.The differences in age,body mass index,diabetes,polycystic ovary syndrome,dysmenorrhea history,existance of abnormal uterine bleeding,and abnormal uterine bleeding time ≥6 months or not were different between the two groups(P<0.05).Age,diabetes,abnormal uterine bleeding,abnormal uterine bleeding time ≥6 months and obesity were independent risk factors affecting endometrial hyperplasia and carcinoma.3.In the group without endometrial hyperplasia or carcinoma,26 cases(40.63%)had oligomenorrhea or irregular bleeding;in the group with endometrial hyperplasia,63 cases(84%)had oligomenorrhea or irregular bleeding.There was a significant difference between the two groups and(P<0.001).4.The sensitivity of hysteroscopy in the diagnosis of endometrial hyperplasia and carcinoma was 73.3%,the specificity was 99.3%,the positive predictive value was98.2%,and the negative predictive value was 87.3%.Conclusions:1.Oligomenorrhea with irregular vaginal bleeding is the main bleeding pattern of endometrial hyperplasia.2.Age,obesity,PCOS,diabetes,existance of abnormal bleeding,abnormal bleeding time≥ 6 months are risk factors for endometrial hyperplasia and carcinoma.3.Hysteroscopy has a high positive predictive value and negative predictive value in the diagnosis of endometrial hyperplasia andcarcinoma.It is helpful for the early detection of endometrial hyperplastic lesions.