Analysis Of Risk Factors For Asymptomatic Endometrial Lesions After Menopause

Objective:To explore the high-risk factors for asymptomatic endometrial leisions in postmenopausal women and analyze the clinical intervention standards for endometrial lesions in asymptomatic postmenopausal patients.Method:A retrospective analysis was conducted on 274 patients who visited Chaohu Hospital affiliated with Anhui Medical University from February 2019 to December2022.Clinical data of patients were collected:age,obesity(according to Chinese standards,adult BMI≥28kg/m~2),hypertension,diabetes,menarche age,menopausal age,pregnancy times,birth times,endometrial thickness,uterine space occupying diameter,uterine fluid volume,endometrial pathological type.To compare the effects of obesity,hypertension,diabetes,early menarche,late menopause,and infertility on endometrial canceration;Calculate the correlation between endometrial thickness,uterine space occupying diameter,and uterine fluid accumulation with endometrial diseases.Statistical analysis was conducted using SPSS 25.0 statistical software. results:1.Comparison of patient age:After menopause,asymptomatic endometrial benign and malignant lesions generally show a trend of first increasing and then decreasing.The incidence rate of benign lesions in all age groups was higher than the incidence rate of malignant lesions in the same age group.50-59 years old was the age group with the largest total incidence of asymptomatic endometrial lesions,and the highest incidence rate of benign and malignant lesions in postmenopausal women.There was no statistical difference in the incidence rate of benign and malignant lesions in different age groups(P=0.205)(P>0.05)05)。2.Comparison of other high risk factors:there were statistically significant differences(P<0.05)in obesity(P=0.015),hypertension(P=0.025),diabetes(P=0.004),and menopausal age(t=-2.867 P=0.009).Among them,obesity,hypertension,and diabetes were independent risk factors for endometrial canceration(OR<1 P>0.05),The age of menopause is an independent risk factor for endometrial malignancy(OR=1.300;95%CI=1.093-1.547;P=0.003).There was no statistically significant difference between endometrial malignancy and age at menarche(P=0.157),gestational age(t=0.999 P=0.319),and parity(t=0.803 P=0.423)(P>0 05)。3.According to the pathological results of patients,there were 11 cases(9.74%)of malignant lesions and 102 cases(90.26%)of benign lesions in the endometrial thickening group(n=113).Endometrial polyps(n=70 61.94%)were the most common type of benign lesions in this group.In the uterine cavity occupying group(n=87),there were 6 malignant lesions(6.90%)and 81 benign lesions(93.10%).The most common pathological type of endometrial benign lesions in this group was endometrial polyps(n=55 63.22%),followed by submucosal fibroids(n=9 10.34%).In the group of uterine cavity effusion(n=74),there were 5 cases of malignant lesions(6.76%)and 69 cases of benign lesions(93.24%).Among the benign endometrial lesions in this group,endometritis(n=50 67.57%)was the most common pathological type.4.Correlation analysis between ultrasound findings and asymptomatic endometrial malignancy after menopause.There was a statistically significant relationship between endometrial thickening(t=-4.652 P=<0.001)(OR=1.505;95%CI=1.206-1.879; P<0.001)and endometrial malignancy.There was no statistically significant relationship between uterine cavity mass(t=2.172 P=0.079),uterine cavity effusion(t=0.249 P=0.814),and endometrial malignancy(P>0.05).5.The intervention threshold of endometrial thickness for benign and malignant endometrial lesions is 9mm,and the diagnostic efficacy is the highest.At this time,the sensitivity is 90.91%,the specificity is 70.59%,the PPV is 25.00%,and the NPV is 98.63%.Conclusion:1.The overall incidence rate of asymptomatic endometrial benign and malignant lesions after menopause increased first and then decreased.50-59 years old is the age group with the highest total incidence of asymptomatic endometrial lesions and the highest incidence rate of benign and malignant lesions after menopause.2.Obesity(BMI≥28kg/m~2),hypertension,diabetes and late menopause are high risk factors for asymptomatic endometrial malignant transformation after menopause,and late menopause is an independent risk factor for endometrial malignant transformation.3.The incidence rate of endometrial malignant lesions was the highest in the endometrial thickening group;When endometrial benign lesions occur,endometrial polyps have the highest incidence rate in endometrial thickening group and uterine cavity occupying group,and endometritis has the highest incidence rate in uterine cavity effusion group.4.Endometrial thickening has clinical value in predicting the occurrence of asymptomatic endometrial malignancy after menopause.Endometrial biopsy is recommended when endometrial thickness is≥9mm;However,uterine space occupying and intrauterine fluid accumulation have no predictive value for the occurrence of endometrial malignancy.