The Clinical Features Of Atypical Endometrial Hyperplasia And Prediction Risk Of Concurrent Endometrial Carcinoma

Objective: To study the clinical features of atypical endometrial hyperplasia and prediction risk of concurrent endometrial cancer.Methods: Collect the clinical data of 171 patients,their preoperative endometrial pathology prompts atypical endometrial hyperplasia and then carry out hysterectomy from January 2007 to January 2017.According to the result of total hysterectomy postoperative pathology,they were divided into atypical endometrial hyperplasia(AEH)group(117cases)and endometrial cancer(EC)group(54 cases),which were retrospectively compared clinical features of two groups,and forecast the risk of endometrial cancer by using logistic regression at the same time.Results: 1.The result of the single factor analysis shows: statistically significant difference(P < 0.05)between endometrial carcinoma and the atypical endometrial hyperplasia group in age,menopausal status,endometrial histological pathology,while in the high blood pressure,diabetes mellitus,serum CA125,serum CA199,the time interval between the initial atypical endometrial hyperplasia diagnosis and the date of hysterectomy,the average number ofdelivery,average endometrial thickness by preoperative vaginal ultrasound or MRI,average weight mass index(BMI),and endometrial sampling methods,there was no statistically significant difference(P > 0.05).2.Logistic regression analysis showed that there are three high risk factors of atypical endometrial hyperplasia combined endometrial cancer---age(≥51.5years old)(OR=3.12,95%CI: 1.59-6.14,P<0.05),postmenopausal(OR=3.39,95%CI:1.66-6.95,P<0.05),severe atypical endometrial hyperplasia(OR=4.46,95%CI:2.47-8.05,P<0.05).3.Without any risk factors,with one risk factor,with two risk factors,with three risk factors of atypical endometrial hyperplasia complicated with endometrial cancer accounted for 11.94%(8/67)、35.71%(20/56)、36.36%(8/22)and69.23%(18/26),the difference was statistically significant(P < 0.05).4.54 cases of typical endometrial hyperplasia in patients with endometrial carcinoma were 31.58%(54/171),and endometrial adenocarcinoma stage I was88.89%(48/54),amomg which the well-differentiated was 70.37 %(38/54).Conclusion: 1.Combined with endometrial cancer,endometrial atypical hyperplasia had higher incidence.Clinically,when a patient’s vagina was found bleeding abnormally,whether she wasjust or more than 51.5 years old or postmenopausal or pathology of severe AEH,there was an increasing risk of endometrial cancer,which should be treated cautiously.2.Endometrial atypical hyperplasia coexisting with endometrial carcinoma is Stage I endometrial adenocarcinoma of much better differentiation.