中老年子宫内膜异位症恶变的风险因素及预后分析

Risk factors and prognosis of endometriosis in middle-aged and elderly patients

目的分析中老年子宫内膜异位症恶变的风险因素及预后情况。方法采取回顾性研究,选取2013年1月至2018年1月石嘴山市第一人民医院诊治的102例接受手术治疗的中老年子宫内膜异位症恶变患者作为观察组,另选取同期的102例单纯子宫内膜异位症行手术治疗的患者作为对照组。比较两组各项资料并以多因素Logistic回归分析中老年子宫内膜异位症恶变的风险因素,随访36个月,通过Kaplan-Meyer生存曲线和Log-rank检验比较组间累计复发率。结果经单因素和多因素Logistic回归分析,年龄≥55岁、绝经状态、卵巢包块最大径≥8cm、子宫内膜异常均是子宫内膜异位症恶变的独立危险因素(P<0.05);经Kaplan-Meyer生存曲线分析,卵巢包块最大径≥8cm的子宫内膜异位症恶变患者36个月累计复发率高于卵巢包块最大径<8cm患者,差异具有统计学意义(P<0.05)。结论绝经状态、卵巢包块最大径≥8cm、子宫内膜异常的中老年子宫内膜异位症患者更容易恶变,预后更差,需要更加密切地随访及积极干预。

Objective To analyze the risk factors and prognosis of endometriosis in middle-aged and elderly patients.Methods A retrospective study was conducted,102 middle-aged and elderly patients with malignant endometriosis who received surgical treatment in Shizuishan First People′s Hospital from January 2013 to January 2018 were selected as the observation group,and 102 patients with simple endometriosis in the same period were selected as the control group.The data of the two groups were compared,and the risk factors of endometriosis in middle-aged and elderly patients were analyzed by multivariate Logistic regression.The follow-up period was 36 months,through the Kaplan-Meyer survival curve calculation and Log-rank test comparison between group recurrence rate.Results Univariate and multivariate Logistic regression analysis showed that age≥55 years,menopausal status,maximum diameter of ovarian mass≥8 cm and endometrial abnormality were independent risk factors for malignant transformation of endometriosis(P<0.05).Kaplan-meyer survival curve analysis showed that the cumulative recurrence rate of malignant endometriosis patients with maximum diameter of ovarian mass≥8 cm was higher than that of patients with maximum diameter of ovarian mass<8 cm,with statistical significance(P<0.05).Conclusions Middle-aged and elderly endometriosis patients with menopausal status,maximum diameter of ovarian mass≥8 cm,and endometrial abnormality are more prone to malignant changes and worse prognosis,requiring closer follow-up and active intervention.