The Clinical And Pathological Analysis On The Relative Risk Factors Of Adenomyosis

Objective:1.To explore the risk factors of uterine adenomyosis(AM),thus to provide reference basis for prevention and control of adenomyosis(AM).2.The related factors of uterine adenomyosis were compared in two groups(localized type and diffuse type),so as to offer scientific basis for clinical treatment and rehabilitation.3.To explore the continual relationships of ectopic glands and in situ glands.This article analyzed the way endometrium grows by morphological changes,and lays a foundation for the future mechanism of disease study.Methods:1.Case-control study was designed with 80 AM patients and 80 healthy control subjects meanwhile.The related factors which possibly are involved in AM were collected;including general situation,birth and menstruation,uterine cavity operation,or other AMrelated diseases was retrospectively analyzed to explore risk factors for incidence in patients.First,univariate Logistic regression model analysis and chisquare test were used by SPSS 21.0,and then multiple-factor Logistic regression analysis was applied for statistically significant factors.2.A case control study was conducted.Patients of AM are grouped into localized type and diffuse type according to their disease patterns.We collect clinical and histological dates of 80 patients with AM,including their age,duration,degree of dysmenorrhea,serum tumor marker CA125 and infiltration degree.Checking of remarkable difference and correlational analyses were conducted by SPSS 21.0.3.Comparative observations were made on the morphology of ectopic glands and in situ glands with general HE staining,and observed by optical microscopes.Results:1.By single factor analysis,vocation,volume of periodic,degree of dysmenorrhea,times of pregnancy,abortion method,artificial abortions times,uterine cavity operation,pelvic operation,uterine fibroids,endometrial hyperplasia/polyps,endometriosis and pelvic inflammation were risk factors.Further multiple-factor Logistic regression analysis identifyed that the dysmenorrhea,artificial abortions times,uterine fibroids,endometrial hyperplasia/polyps and endometriosis are independent risk factors for AM.The risk of AM increased 3.373 times when the women's dysmenorrhea degree increased one grade.The women with history of abortion had a 9.963-fold increased risk of AM than those without it.Similarly,women who underwent a medical abortion had a 3.927-fold increased risk.When compared with those with no other diseases,women accompanied with ovarian endometriosis had a 31.230-fold increased risk of AM,women with uterine fibroids had a 14.133-fold increased risk for AM,women with endometrial hyperplasia or polyp had a 10.650-fold increased risk for AM.2.Combined Mann-Whitney U rank sum test and Spearman Order Correlation methods revealed that duration,degree of dysmenorrhea,ovarian volume,serum tumor marker CA125 and ectopic endometrium infiltration degree are significantly related to AM types.3.In morphological terms,the glands and stroma showed similar appearance in myometrium and in normal endometrium,which suggested that the ectopic glands and stroma may have at its root the same endometrium,supporting the “basal endometrium invagination” theory.Conclusion:1.The dysmenorrhea,artificial abortions times,uterine fibroids,endometrial hyperplasia/polyps and endometriosis are independent risk factors for AM,and contribute to scientific basis for clinical treatment and rehabilitation.2.That duration,degree of dysmenorrhea,ovarian volume,serum tumor marker CA-125 and ectopic endometrium infiltration degree are significantly related to AM types.These indicators are helpful to clinical diagnosis and the selection of therapy.3.The ectopic glands and stroma may have at its root the same endometrium,supporting the “basal endometrium invagination” theory.