Risk Factors And Postoperative Pathological Analysis Of Postmenopausal Endometrial

ObjectiveTo explore the risk factors of postmenopausal endometrial carcinoma by comparative analysis,and to analyze the clinicopathological features of endometrioid adenocarcinoma and non-endometrioid carcinoma in order to provide the basis for the development of personalized therapy.MethodsThis study retrospectively analyzed the clinical data of 420 patients with gynecological gynecology at the General Hospital of Ning Xia Medical University from January 2012 to December 2016 with "postmenopausal vaginal bleeding" as the main clinical manifestation.Including 240 cases of endometrial cancer patients,180 cases of non-endometrial cancer patients,comparative analysis of the incidence of related factors;240cases of endometrial cancer patients according to the clinical pathological categories were divided into endometrial adenocarcinoma 196 cases,non-endometrium 44 cases of carcinoid were compared,the clinical-pathological stage,histological grade,depth of myometrial invasion and expression of ER and PR were analyzed.The main factors of the survey were analyzed by single factor chi-square test and multivariate conditional logistic regression analysis.The correlation between the endometrial carcinoma and the study factors was measured by the odds ratio(OR)of the relative risk.The confidence interval(95% CI)was the bilateral estimate,the standard ? was 0.05,the pathological features were counted Analysis using chi-square test,expressed in terms of rate.Results1.The age of postmenopausal endometrial cancer was mainly in the stage of 57-61 years old,96 cases(40%),endometriosis carcinoma age of 47-77 years old,the average age of onset was 60.03 ± 7.88 years old,non-uterine The age of onset of membranous carcinoma was49-75 years,with an average age of 63.62 ± 5.32 years.There was significant difference in the average age of two endometrial carcinoma(P <0.01).2.The single factor analysis showed that the age of menarche,age of menopause,hypertension,diabetes mellitus,body mass index,tamoxifen,family history of malignant tumor,experimental group and control group were statistically significant(P <0.05).Non-conditional multivariate logistic regression analysis showed that the family history of diabetes mellitus,diabetes mellitus,obesity,infertility and malignant tumor were statistically significant(P < 0.05),OR> 1,is an independent risk factor for postmenopausal endometrial cancer.3.There were 196 cases of endometrioid adenocarcinoma,including 147 cases of G1 grade,49 cases of G2 / G3 grade and 44 cases of non-endometrial carcinoma,including 14 cases of G1 grade and 30 cases of G2 / G3 grade.The difference was statistically significant(P<0.01).Endometrioid adenocarcinoma in I / II in 178 cases,III / IV in 18 cases.Non-endometrioid carcinoma in I / II in 32 cases,III / IV in 12 cases.The difference was statistically significant(P <0.01).Endometrioid adenocarcinoma,myometrial invasion depth of> 1/2 of the 22 cases,? 1/2 of 174 cases;rather than endometrial carcinoma,myometrial invasion depth of ? 1/2 of 32 cases,1/2 of 12 cases.The difference was statistically significant(P <0.05).4.G1 grade in the postmenopausal 6-10 years age composition ratio(83.08%)higher than the other five groups,G2 / G3 grade in the postmenopausal 16-20 years age composition ratio(57.14%)high In the other five groups.The difference between the two groups was statistically significant(P <0.01).The compositional ratios of G1,G2 and G3 were88.20%,77.78% and 50%,respectively,in the myometrial invasion or superficial myometrialinvasion(? 1 / 2),G1,G2,The composition ratio of G3 is 11.80%,22.22% and 50%respectively.There was significant difference between G1 and G2 and G3 groups(P <0.01).5.There were 25 cases of negative expression of ER and PR in non-endometrioid carcinoma group and 14 cases of negative expression.Endometrioid adenocarcinoma ER?PR expression were(+)137 cases,the expression of(-)33 cases.The difference was statistically significant(P <0.05).The expression of ER and PR in the I / II lesions was positive in 156 cases,the ratio was 83.87%,the negative cases were 30.13%,the ratio was 16.13%,and the expression of ER and PR in the III / IV patients was 6 cases(26.09 %)Were negative in 17cases(73.91%).The difference was statistically significant(P <0.01).There were 113 cases(82.48%)and negative in 24 cases(17.52%)of ER and PR in G1 grade.There were 49 cases of ER and PR in G2 / G3,the ratio was 68.06% Example,the ratio is 31.94%.The difference was statistically significant(P <0.05).Conclusion1.Postmenopausal endometrial cancer is concentrated in the 57-61 years old,and type II endometrial cancer are older than the age of type I;postmenopausal 6 to 10 years the incidence of high differentiation,16-20 years are mostly medium and low differentiation.2.early menarche,late menopause,hypertension,diabetes,BMI ? 28 kg / m2,not pregnant,a family history of malignant tumors,the use of tamoxifen treatment of postmenopausal endometrial cancer risk factors.3.The positive rate of early stage,well differentiated,superficial myometrial invasion and ER and PR expression in postmenopausal type I endometrial carcinoma was higher than that in type II.