围绝经期妇女子宫内膜息肉不同病理类型与性激素的相关性分析

Correlation between different pathological types of endometrium polyps and sex hormones in perimenopausal women

目的分析围绝经期妇女子宫内膜息肉不同病理类型与性激素的相关性。方法回顾性分析该院2014-01~2017-06行子宫内膜息肉手术的134例围绝经期妇女的临床资料、子宫内膜息肉不同病理类型与性激素指标间的相关性,评估性激素相关指标在子宫内膜息肉病变进展中的作用。结果 134例患者的子宫内膜息肉病理组织类型为单纯性增生92例(68.66%),复杂性增生36例(26.87%),单纯性增生伴非典型性4例(2.98%),复杂性增生伴非典型性2例(1.49%)。病理组织类型与患者卵泡雌激素均值、黄体生成素均值、泌乳素均值、孕激素均值无明显相关(P>0.05);但与雌激素均值、年龄呈线性正相关(r_1=0.293,P_1=0.001;r_2=0.355,P_2=0.000),雌激素越高、年龄越大,组织恶变倾向越大;与雄激素均值呈线性负相关(r=-0.299,P=0.000),雄激素的下降增加了组织恶变的风险。结论雌激素、雌激素与雄激素结合,在预测围绝经期子宫内膜息肉的恶变风险有一定的参考价值,对发现子宫内膜息肉恶变倾向上比组织病理检查更具无创性,值得临床上进一步探讨。

Objective To analyze the correlation between the different pathological types of endometrium polyps and sex hormones in perimenopausal women.Methods The clinical data of 132 perimenopausal women receiving the surgery for endometrial polyps in our hospital from January 2014 to June 2017 were retrospectively analyzed.The correlation between the different pathological types of endometrium polyps and the sex hormone indexes was analyzed to evaluate the role of sex hormone related indicators in the development of endometrium polyps.Results In the 134 patients,the pathological type of endometrium polyps was simple hyperplasia in 92 case(68.66%),complex hyperplasia in 36 cases(26.87%),atypical hyperplasia of simple hyperplasia in 4 cases(2.98%),and atypical hyperplastic hyperplasia in 2 cases(1.49%).There were no significant correlations between the pathological types and the mean follicular estrogen,the mean luteinizing hormone,the mean prolactin hormone and the mean progesterone of the patients(P>0.05).There were positive linear correlations between the pathological types and the mean estrogen and age(r 1=0.293,P 1=0.001;r 2=0.355,P 2=0.000).With the increase of mean estrogen and age,the potentiality of canceration of the tissues was greater,and there was a negative correlation between the mean androgen and pathological types(r=-0.299,P=0.000).With the decrease of mean androgen,the risk of tissue malignancy increased.Conclusion The combination of estrogen and androgen has a certain reference value in predicting the risk of malignant transformation of endometrial polyps and it is more noninvasive than histopathological examination in detecting the malignant transformation tendency of endometrial polyps in perimenopausal women.