Clinical Analysis Of Hysteroscopy In The Diagnosis Of Intrauterine Occupational Diseases Of Postmenopausal Women

Objective1.Analysis the distribution of intrauterine occupational diseases ofpostmenopausal women and its relationship with age, menopause age and postmenopausalbleeding.2.To investigate the diagnostic value of hysteroscopy in intrauterine occupationaldiseases of postmenopausal women.Methods We conducted a retrospective chart review of320postmenopausal women whohave been proven uterine placeholder by ultrasound.The320cases were examined underwentbiopsy with hysteroscopy, and tissues were taken for pathology examination. According tothat whether the age is greater than60age,menopausal age is more than10years, whetherthere is bleeding symptoms, we divided the patients into two groups. Compared thedistribution of diseases two groups,and investigate the relationship of intrauterineoccupational diseases and age,menopause age and postmenopausal bleeding.Analysishysteroscopy operation situation and the diagnosis results,and compare of diagnostic resultsof hysteroscopy and ultrasound.Results1.The final pathology report from the submitted hysteroscopic samples wasendometrial polyp60.0%（192/320）,fibroid18.4%（59/320）, endometrial hyperplasia10.3%（33/320）,endometrial inflammation5.6%（18/320）and endometrial cancer5.6%（18/320）.2.7were found to have malignant lesions in patients of more than60years of age and11were found in less than60years of age.7were found to have malignant lesions in patientswhose menopausal age is more than10years and11were found in whose menopausal age isless than10years.117were found to have endometrial polyp in bleeding patients and75were found in non-bieeding patients，（P<0.05）.17were found to have endometrial cancer inbleeding patients and1were found in non-bieeding patients（P<0.05).3.There were222cases in benign disease that we observed vessels,then,17cases inendometrial cancer.16of endometrial cancer with atypical vessels.4.Hysteroscopy presented93.75％sensitivity,89.89％specificity, positive predictivevalue of93.26％，negative predictive value of90.55％,and accuracy of92.19％for theendometrial polyp.Hysteroscopy presented91.53％、98.47％、93.10％、98.09％and97.19％for the fibroid.Hysteroscopy presented94.44％、99.01％、85.00％、99.67％、98.75％forthe endometrial inflammation.Hysteroscopy presented51.52％、96.52％、62.96％、94.54％、91.88％for the endometrial hyperplasia.Hysteroscopy presented89.89％、98.01％、72.73％、99.33％、97.50％for the endometrial cancer.5.ComParison of the two methods in the sensitivity,specificity,positive predictivevalue,negative predictive value and accuracy,hysteroscopy was better than ultrasound indiagnosis of endometrial PolyPs(P<0.05).There was no difference in thesensitivity,specificity,positive predictive value,negative predictive value and accuracybetween hysteroscopy and ultrasound in diagnosis of endometrial fibroids(P>0.05).ComParison of the two methods in the specificity,positive predictive value andaccuracy, hysteroscopy was better than ultrasound in diagnosis of endometrial hyperplasia(P<0.05). There was no difference in the sensitivity and negative predictive value betweenhysteroscopy and ultrasound in diagnosis of endometrial hyperplasia (P>0.05). ComParison ofthe two methods in the sensitivity and negative predictive value, hysteroscopy was better thanultrasound in diagnosis of endometrial cancer (P<0.05). There was no differencespecificity,positive predictive value and accuracy between hysteroscopy and ultrasound indiagnosis of endometrial cancer (P>0.05).6.We treated152persons in the study with hysteroscopy.Conclusion1.The occupational diseases in uterine cavity of postmenopausal patients mainly is benign disease.Endometrial polyps are the most common.2. Patients with intrauterine occupational diseases,the greater the age and the longer aftermenopause,the more need to be mindful of malignant lesions.3. Endometrial cancer was more prevalent in women with bleeding than in women withno bleeding. But there is still endometrial cancer in patients of non-bleeding.4.The hysteroscopy has the advantage of vivacity, comprehensiveness and veracity.Hysteroscopy is the best method to confirm the diagnosis of intrauterine occupational diseasesof postmenopausal women.