18398例子宫内膜诊刮结果临床病理分析

Clinicopathological analysis of endometrial curettage results in 18 398 cases

目的探讨子宫内膜诊刮和病理诊断的临床意义。方法回顾性分析2010年1月至2017年12月该院子宫内膜诊刮18 398例患者病理结果,并进行临床病理分析。结果诊刮子宫内膜患者发病率位于前三的疾病分别为与妊娠相关疾病35.1%(6 464/18 398),子宫内膜增生31.2%(5 742/18 398)和子宫内膜息肉15.8%(2 898/18 398)。子宫内膜增生又分为子宫内膜增生紊乱、单纯性增生、复杂性增生和非典型性增生,所占比例分别为47.1%(2 703/5 742)、44.5%(2 555/5 742)、6.1%(353/5 742)和2.3%(131/5 742)。与妊娠相关子宫内膜诊刮患者中,各种原因流产导致刮宫占61.4%(3 968/6 464)。不孕症患者子宫内膜诊刮结果显示正常内膜42.8%(317/740),子宫内膜增生42.7%(316/740),炎症7.7%(57/740),子宫内膜息肉6.5%(48/740),子宫内膜癌0.3%(2/740)。结论子宫内膜诊刮患者最常发生的疾病是与妊娠相关疾病、子宫内膜增生和子宫内膜息肉,且不同疾病发生年龄段不同,与妊娠相关疾病子宫内膜病变主要是各种流产,不孕症患者子宫内膜诊刮需要高度重视。

【Objective】 To explore the clinical significance of endometrial curettage and pathological diagnosis. 【Methods】 The pathological results of 18 398 cases of endometrial curettage in our hospital from January 2010 to December 2017 were retrospectively analyzed.【Results】The top three diseases were pregnancy-related diseases 35.1%(6 464/18 398), endometrial hyperplasia 31.2%(5 742/18 398) and endometrial polyps 15.8%(2 898/18 398). Endometrial hyperplasia was divided into endometrial dysplasia,simple hyperplasia, complex hyperplasia and atypical hyperplasia, accounting for 47.1%(2 703/5 742), 44.5%(2 555/5 742), 6.1%(353/5 742) and 2.3%(131/5 742), respectively. Among pregnancy-related endometrial curettage patients, 61.4%(3 968/6 464) were caused by abortion of various causes. The results of endometrial curettage showed that 42.8%(317/740) of normal endometrium,42.7%(316/740) of endometrial hyperplasia, 7.7%(57/740) of inflammation, 6.5%(48/740) of endometrial polyps and 0.3%(2/740)of endometrial cancer were found in infertility patients. 【Conclusion】 The most common diseases of endometrial curettage patients are pregnancy-related diseases, endometrial hyperplasia and endometrial polyps, and different diseases occur at different ages. Endometrial lesions of pregnancy-related diseases are mainly abortions. Endometrial curettage in infertility patients should be highly valued.