Clinical Analysis Of 533 Postmenopausal Endometrial Lesions

Objective:By analyzing the pathological results and clinical data of patients with postmenopausal endometrial lesions,the clinical characteristics of patients with postmenopausal endometrial lesions were studied to facilitate the early detection,early diagnosis and early treatment of postmenopausal AH/EC patients.MethodFrom January 2015 to December 2020,533 cases of postmenopausal endometrial lesions underwent diagnostic curettage or hysteroscopy at the first affiliated Hospital of Nanchang University were selected as the subjects,clinical data of patients were collected: including age,menopausal age,menopausal years,whether complicated with hypertension,whether complicated with diabetes,whether complicated with infertility,whether complicated with postmenopausal bleeding(PMB),endometrial thickness,and pathological results.With or without postmenopausal bleeding,divided into PMB and PMB groups,The pathological results of the two groups were analyzed;divided into AH/EC group and benign lesion group(all pathological types except AH/EC)according to pathological results,The clinical data of the two groups were analyzed.Statistical analysis using SPSS26.0 software package.The measurement data are expressed by mean ± standard(x ±s)deviation,the measurement data of normal distribution between the two groups are analyzed by independent sample T test,and the counting data are expressed by percentage(%),chi-square test is used between the two groups,single factor analysis is used to AH /EC the high risk factors,and then multi-factor regression analysis is carried out to obtain AH /EC independent risk factors.The best cut-off value was determined according to sensitivity,specificity and ROC curve,and the difference of P<0.05 was statistically significant.Results1.533 cases of postmenopausal endometrial disease,endometrial polyps168(31.52%),submucous leiomyoma 26(4.88%),inflammation 28(4.32%),atypical endometrial hyperplasia 23(5.25%),AH 7(1.31%),EC 139(26.08%),other types142(26.64%).193 patients in PMB group(36.21%),Among them AH patient 1,EC 6patients;340 patients in PMB group(63.79%),Among them AH 6 patients,133 EC patients.The incidence of EC in PMB group(39.12%)was significantly higher than that in non PMB group(3.11%),P<0.001,The difference was statistically significant.2.increased age,postmenopausal bleeding,combined with diabetes,infertility increases the risk of AH/EC in postmenopausal women;combined with PMB and diabetes is an independent risk factor for AH/EC.3.By analyzing the pathological types and endometrial thickness of patients without PMB endometrial thickening: the endometrial polyps are the most common pathological types in patients without PMB endometrial thickening;Endometrial thickness was 11,15,23,17 mm,in 3 EC and 1 AH,Average(16.5 ± 5.00)mm,There were significant differences in endometrial thickness between AH/EC and atrophic endometrium in patients with benign lesions without atypical hyperplasia and other types of endometrium(B ultrasound showed abnormalities,pathological results showed atrophic endometrium,proliferative endometrium,etc.)AH/EC the thickest endometrium in patients(P<0.05).4.The diagnostic value of endometrial thickness in patients without PMB endometrial thickening :15 mm as the boundary value of diagnosis AH/EC with a high diagnostic efficacy,Jordan index of 0.60,see Table 5,but 15 mm as the boundary value will be 1 case of endometrial carcinoma(11mm)missed diagnosis.Conclusion1.Increasing menopausal life,combined with diabetes,postmenopausal bleeding is a risk factor for endometrial cancer in postmenopausal women;the older,infertile postmenopausal endometrial lesions,should be alert to the occurrence of endometrial cancer.2.In patients without AH/EC risk factors without postmenopausal bleeding,beware of endometrial lesions and cancers in patients with endometrial thickness of≥ 11mm.