Analysis Of Pathological And Clinical Characteristics Of Abnormal Uterine Bleeding In The Perimenopausal Transition

Objective:The pathological and clinical characteristics of abnormal uterine bleeding in the perimenopausal transition are analyzed,and the affecting factors of endometriosis in those patients are discussed.The aim is this paper to remind explore the influencing factors of endometrial malignancy,and to provide suggestions and theoretical basis for clinician doctors on prevention,screening and early diagnosis of endometrial cancer.Methods:296 perimenopausal patients who are admitted from the department of gynecology of the first hospital of Lanzhou university from January 2016 to September 2019 due to abnormal uterine bleeding retrospectively are analyzed.According to the pathological results,precancerous lesions(28 patients with atypical hyperplasia)are excluded.The remaining 268 patients are divided into two groups,the endometrial benign lesion group is consisted of 221 patients,and 47 patients are in the malignant lesion group.Collecting the clinical datum of patients,such as age,body mass index(BMI),age of menarche,the number of pregnancy,delivery times,the number of abortion,bleeding time,past medical history(hypertensive disease,diabetes,hyperlipidemia,thyroid disease,the use of estrogen drugs,genital tract inflammatory disease),family history and ultrasound examination results(endometrial thickness,endometrial echo and blood flow signal).The chi-square test and T test are used for multi-factor analysis,and then binary logistic regression is used for multi-factor analysis.Results:The pathological types of perimenopausal patients with abnormal uterine bleeding are mainly benign which accounts for 82.5%,and the number of malignant lesions is small which accounts for 17.5%.Single factor analysis shows that age(?50 years),obesity(BMI?25 kg/m~2),age of menarche(?12years),the frequency of pregnancy(?1),family history,endometrial thickness(?10 mm),endometrial echo(uneven),endometrial blood flow signals(PI and RI)are the risk factors of endometrial malignant transformation(P<0.05).Logistic regression analysis shows that age(?50years),obesity(BMI?25kg/m~2),and endometrial thickness(?10mm)are independent risk factors for endometrial malignancy(P<0.05).There are no statistical differences between the two group in the number of births,number of abortions,bleeding time(?6 months),thyroid disease,the use of estrogen drugs and the genital tract inflammatory disease(P>0.05).Conclusion:The pathological types of abnormal uterine bleeding are mainly benign lesions in the perimenopausal transition.Age(?50 years),obesity(BMI?25kg/m~2),family history,endometrial thickness(?10 mm)are the affecting factors for endometrial malignancy.Therefore,the patients with endometrial malignant risk factors should be given early intervention measures,and attention should be paid to the screening work to strengthen the early diagnosis method.