异常子宫出血患者子宫内膜厚度与组织病理学的相关性分析

Correlation analysis of endometrial thickness and histopathology in patients with abnormal uterine bleeding

目的观察异常子宫出血(AUB)患者子宫内膜厚度,并分析其与组织病理学的关系。方法选取2019年1月至12月本院接收的60例AUB患者,全部患者入院时均接受阴道超声检查,检测患者子宫内膜厚度,超声检查后次日进行诊断性刮宫并送至病理检查;记录并分析60例AUC患者子宫内膜病理学类型,比较不同病理学类型患者子宫内膜厚度,并分析二者的关系。结果60例AUB患者经刮宫、病理检查结果显示,有11例患者为子宫恶性病变,占18%,其中子宫内膜癌6例、子宫内膜间质肉瘤5例;有49例患者良性病变,占82%,其中23例子宫肌瘤、5例宫颈息肉、4例子宫内膜息肉、6例子宫内膜异位症、11例其他;恶性病变组患者子宫内膜厚度显著高于良性病变,差异有统计学意义(P<0.05);绘制ROC曲线结果显示,子宫内膜厚度预测AUB患者组织恶性病变高风险的AUC为0.849,有一定预测价值。结论AUB患者子宫内膜厚度与组织病理学类型有一定联系,子宫内膜厚度异常升高提示内膜恶性病变风险,可考虑早期检测AUB患者子宫内膜厚度,对指导早期评估、干预子宫内膜癌提供基础。

Objective To observe the endometrial thickness of patients with abnormal uterine bleeding(AUB)and analyze its relationship with histopathology.Methods Sixty AUB patients received in our hospital from January 2019 to December 2019 were selected.All patients underwent vaginal ultrasound examination upon admission to detect the thickness of the patient′s endometrium.After ultrasound examination,diagnostic curettage was performed the next day and sent to pathology,recorded and analyzed the endometrial pathological types of 60 patients with area under the curve(AUC),compared the endometrial thickness of patients with different pathological types,and analyzed the relationship between them.Results The results of 60 AUB patients with curettage and pathological examination showed that 11 patients had malignant uterine lesions,accounting for 18%,including 6 endometrial cancer and 5 endometrial stromal sarcoma;49 patients had benign lesions,accounted for 82%,including 23 cases with uterine fibroids,5 cases with cervical polyps,4 cases with endometrial polyps,6 cases with endometriosis,and 11 cases with others;the endometrial thickness of the patients in the malignant lesion group was significantly higher than that of the benign lesions.The difference was statistically significant(P<0.05),the results of drawing receiver operating characteristic(ROC)curve showed that the AUC of endometrial thickness predicting the high risk of tissue malignant lesions in AUB patients was 0.849,which has certain predictive value.Conclusion Endometrial thickness in patients with AUB is related to histopathological types.Abnormally elevated endometrial thickness indicates the risk of endometrial malignancy.Early detection of endometrial thickness in patients with AUB can be considered to provide the basis for early evaluation and intervention of the endometrium.