278例绝经10年以上妇女子宫内膜病理结果分析

Pathological analysis of endometrium in 278 postmenopausal women over 10 years of menopause

目的探讨绝经10年以上妇女子宫内膜厚度(ET)与病理结果的关系.方法回顾性分析2013年12月至2015年8月期间绝经10年以上在门诊行诊断性刮宫的278例妇女的病理资料,根据术前阴道超声检测ET,分为ET<5 mm、5 mm≤ET<10 mm、ET≥10 mm及宫腔占位4组,比较各组病理结果情况;术后根据病理结果分为正常、子宫内膜息肉、恶性肿瘤和其他4组,分析比较各组ET的差异.结果 278例妇女中,发现子宫内膜恶性28例(26例子宫内膜恶性肿瘤+不典型增生2例),子宫内膜息肉134例,正常内膜97例,其他19例;26例子宫内膜恶性肿瘤患者中有22例内膜恶性肿瘤患者,其中仅1例因体检子宫内膜增厚就诊,其余均因阴道流血就诊.不同ET子宫内膜组内膜恶性肿瘤比较,差异无统计学意义.恶性肿瘤组ET(10.6 mm)大于病理正常组(5.3 mm),差异有统计学意义.结论绝经后阴道流血仍是病理诊断的首要指征,诊断性刮宫是安全、简便、准确率高的方法.

Objective To investigate the relationship between endometrial thickness(ET) and pathological diagnosis in postmenopausal women over 10 years of menopause.Methods The pathological data of 278 postmenopausal women who underwent diagnostic curettage for more than 10 years from December 2013 to August 2015 were retrospectively analyzed.According to the preoperative transvaginal ultrasonography of ET,four groups was divided:ET < 5 mm,5 mm < ET < 10 mm,ET < 10 mm and intrauterine abnormal occupancy.The pathological results of each group were compared.The patients were divided into 4 groups:normal,endometrial polyps,malignant endometrial carcinoma and others according to the pathological results.The differences of ET in each group were analyzed and compared.Results Among 278 women,28 cases were Malignant Endometrium,134 were endometrial polyps,97 were normal endometrium and 19 were others.22 cases were diagnosed malignant endometrial carcinoma among 26 patients with malignant endometrial carcinoma,only one case sought medical advice due to endometrial thickening which found in physical examination,and others were treated for vaginal bleeding.There was no significant difference in endometrial malignant tumors between different ET endometrial groups.ET in malignant tumors group (10.6 mm) was higher than that in pathological normal group (5.3 mm),and the difference was statistically significant.Conclusion Postmenopausal vaginal bleeding was the primary indication of pathological diagnosis.Diagnostic curettage is a safe,simple and accurate method.