无症状的绝经后妇女子宫内膜增厚的子宫内膜癌

L. Mladenović-Segedi, M. Pantelić, D. Stajic
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摘要

介绍。子宫内膜癌最常见的临床表现是绝经后出血,以及不规则子宫出血。很少,子宫内膜癌也可能出现在绝经后妇女无出血。我们研究的目的是检查无症状的绝经后子宫内膜增厚妇女子宫内膜癌的发病率。材料和方法。研究对象为251名经超声诊断子宫内膜厚度大于4mm的无症状绝经后妇女。所有患者都进行了探索性刮除,然后对获得的材料进行了组织病理学检查。结果。受访者的平均年龄为65.38岁。26.69年。子宫内膜平均厚度15.68 ?5.06毫米。70.13%的患者表现为子宫内膜良性病变;子宫内膜息肉占58.18%,子宫内膜单纯性增生无异型性占11.95%。1.59%的患者发现子宫内膜癌,0.4%的患者发现卵巢癌转移,1.59%的患者发现子宫内膜增生伴异型。子宫内膜厚度大于11mm的患者均可诊断为子宫内膜癌。结论。无症状的子宫内膜增生妇女的治疗方法应因人而异。对于子宫内膜厚度大于11mm的患者,建议行探查性刮除/宫腔镜检查,以发现和评估子宫内膜癌。子宫内膜厚度为4 - 10mm的无症状女性应进一步检查,特别是当相关危险因素或其他超声参数提示子宫内膜病理更严重时。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endometrial carcinoma in asymptomatic postmenopausal women with a thickened endometrium
Introduction. The most common clinical manifestation of endometrial cancer is postmenopausal bleeding, as well as irregular uterine bleeding. Far less often, endometrial cancer may also be present in postmenopausal women without bleeding. The aim of our study was to examine the incidence of endometrial cancer in asymptomatic postmenopausal women with a thickened endometrium. Material and Methods. The research included 251 asymptomatic postmenopausal women with endometrial thickness over 4 mm established by ultrasound. Exploratory curettage was performed in all the patients, followed by histopathological examination of the obtained material. Results. The average age of the respondents was 65.38 ? 26.69 years. The average thickness of the endometrium was 15.68 ? 5.06 mm. Of all the patients, 70.13% presented with benign endometrial disease; endometrial polyps were found in 58.18% and simplex hyperplasia of the endometrium without atypia in 11.95%. Endometrial cancer was found in 1.59% of patients, ovarian cancer metastasis in 0.4%, and endometrial hyperplasia with atypia in 1.59% of patients. All cases of endometrial cancer were diagnosed in patients with endometrial thickness over 11 mm. Conclusion. The approach to asymptomatic women with endometrial hyperplasia should be individual. Exploratory curettage/hysteroscopy should be recommended to patients with endometrial thickness over 11 mm in order to detect and evaluate for endometrial cancer. Asymptomatic women with endometrial thickness of 4 - 10 mm should be further examined, especially in case of associated risk factors or other ultrasound parameters that indicate more serious endometrial pathology.
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