绝经前子宫异常出血妇女子宫内膜取样中子宫内膜癌和增生的发生率。

Przeglad lekarski Pub Date : 2017-01-01
Iwona Gawron, Magdalena Łoboda, Dorota Babczyk, Inga Ludwin, Paweł Basta, Kazimierz Pityński, Artur Ludwin
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引用次数: 0

摘要

异常子宫出血(AUB)是子宫内膜癌(EC)和子宫内膜增生伴AH或不伴EH异型的最常见症状。绝经前妇女患恶性肿瘤和增生的风险明显低于绝经后妇女。只有10%的乳腺癌发生在绝经前。肥胖和年龄是公认的子宫内膜癌的危险因素。子宫内膜取样是建议子宫内膜恶性肿瘤高风险的妇女。主要目的是确定因AUB而行扩张刮除术(D&C)的绝经前妇女EC、AH和EH的发生率。该研究的另一个目的是根据PALM-COEIN分类,估计有两种AUB类型的超重和肥胖女性发生EC和AH的风险:重度月经出血(AUB- hmb)和月经间出血(AUB- imb)。材料与方法:对2016年1月至2016年12月因AUB在三级医院行D&C的女性进行回顾性研究。确定了EC、AH、EH的发病率。评估年龄、BMI、AUBHMB/AUB-IMB对异常组织学(EC、AH、EH)发生的影响。最后,通过反向逐步回归和v-fold交叉验证机制建立的模型没有统计学意义的关系。结果:2/213例中检出EC (0.9%;95% CI 0.0003 ~ 0.036), 3/213例AH(1.4%),总共5/213例(2.3%)女性患有AH orEC。213名妇女中有16名(7.5%)检出EH。高BMI增加ah诊断的机会:OR 1.16 (95% CI 1.05-1.28)。与IMB相比,HMB的存在降低了EH的机会:OR0.24 (95% CI 0.07-0.9)。与hmb相比,IMB使EH的诊断机会增加4.11倍(OR 4.1, 95% CI 1.1-14.9;P = 0.016)。结论:绝经前aub行D&C的妇女发生EC是罕见的。有必要寻找比常用的更有效的患者选择方法。年龄和体重指数似乎不应该作为选择患者的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endometrial cancer and hyperplasia rate in women before menopause with abnormal uterine bleeding undergoing endometrial sampling.

Introduction: Abnormal uterine bleeding (AUB) is the most common symptom of endometrial cancer (EC) and endometrial hyperplasia with (AH) or without (EH) atypia. Risk of malignancy and hyperplasia is significantly lower in premenopausal than in postmenopausal women. Only 10% of EC occurs before menopause. Obesity and age are well-recognized risk factors of endometrial cancer. Endometrial sampling is recommended in women at high risk of endometrial malignancy. The primary objective was to determine the incidence of EC, AH and EH in premenopausal women undergoing dilation and curettage (D&C) because of AUB. Additional objective of the study was to estimate the risk of EC and AH in overweight and obese women with two types of AUB: heavy menstrual bleeding (AUB-HMB) and intermenstrual bleeding (AUB-IMB), according to PALM-COEIN classification.

Material and methods: Retrospective study in the population of women undergoing D&C in tertiary hospital because of AUB between Jan-2016 and Dec-2016. The incidence of EC, AH, EH was established. The influence of the variables: age, BMI, AUBHMB/ AUB-IMB on the occurrence of abnormal histology (EC, AH, EH) was evaluated. Finally, the model built by using backward stepwise regression and mechanism of v-fold cross-validation, showed no statistically significant relationship.

Results: EC was detected in 2/213 cases (0.9%; 95% CI 0.0003 to 0.036), AH in 3/213 cases (1.4%), giving a total of 5/213 (2.3%) women with AH or EC. EH was detected in 16/213 (7.5%) women. High BMI raises the chance of AH diagnosis: OR 1.16 (95% CI 1.05- 1.28). The presence of HMB compared to IMB reduces the chance of EH: OR 0.24 (95% CI 0.07-0.9). IMB increases the chance for the diagnosis of EH 4.11 times compared to HMB (OR 4.1, 95% CI 1.1-14.9; p = 0.016).

Conclusions: EC in premenopausal women with AUB undergoing D&C is rare. There is a need to search for more effective methods of selection of patients than commonly used. Age and BMI do not seem to be factors that should be used to select patients.

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