子宫内膜息肉发病及恶变的临床因素分析

Analysis of clinical factors for endometrial polyps and canceration

目的研究子宫内膜息肉(EP)发病的原因及出现恶变的影响因素,为该疾病的预防以及治疗给予数据支持。方法选取2018年1月至2020年12月就诊于北京市大兴区中西医结合医院妇科的243例彩超提示可疑EP患者作为研究对象,所有患者均进行宫腔镜检查,对患者的临床信息进行详细记录,包括症状体征、年龄、体重指数(BMI)、宫内节育器放置史、孕产次、宫颈息肉、子宫肌瘤、子宫腺肌病、高血压、糖尿病等临床资料,依照病理数据将其分成对照组(24例)、EP良性组(197例)和EP恶性组(22例),采用单因素以及多因素logistic回归分析EP发病及恶变的危险因素。结果单因素分析结果显示,EP良性组与对照组的宫内节育器、宫颈息肉、子宫肌瘤、肥胖以及糖尿病发生率比较,差异有统计学意义(P<0.05);EP良性组与EP恶性组的月经淋漓不净、肥胖以及高血压发生率比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,宫颈息肉(β=2.19,OR=3.47,95%CI=1.552~7.181)、子宫肌瘤(β=1.83,OR=2.30,95%CI=0.691~7.660)、肥胖(β=1.91,OR=2.02,95%CI=0.082~10.157)是EP发病的危险因素(P<0.05);月经淋漓不净(β=1.53,OR=2.39,95%CI=1.240~8.871)、肥胖(β=2.96,OR=2.45,95%CI=1.552~7.088)是EP恶变的危险因素(P<0.05)。结论宫颈息肉、子宫肌瘤、肥胖是EP发病的独立危险因素;月经淋漓不净、肥胖是EP恶变的独立危险因素。

Objective To investigate the clinical factors of endometrial polyps(EP)and canceration,to provide evidence for clinical prevention and treatment.Methods From January 2018 to December 2020,the ultrasound examination in Integrated Traditional Chinese and Western Medicine Hospital of Daxing District showed 243 patients with suspected EP were selected as the research objects.All patients underwent hysteroscopy.The clinical symptoms,signs,age,body mass index(BMI),intrauterine device,gravidity and parity,cervical polyp,hysteromyoma,adenomyosis,diabetes,hypertension of the patients were recorded.According to pathological results,they were divided into control group(24 cases),benign EP group(197 cases)and malignant EP group(22 cases).The single-factor,multi-factor logistic regression analysis were used to investigate the risk factors of EP.Results Univariate analysis results showed that the differences in intrauterine device,cervical polyp,hysteromyoma,obesity,diabetes between benign EP group and control group were statistically significant(P<0.05).The differences in hysteromyoma,obesity and menstruation is not clean between benign EP group and malignant EP group were statistically significant(P<0.05).Multivariate logistic regression analysis showed that cervical polyp(β=2.19,OR=3.47,95%CI=1.552-7.181),hysteromyoma(β=1.83,OR=2.30,95%CI=0.691-7.660)and obesity(β=1.91,OR=2.02,95%CI=0.082-10.157)were risk factors of the onset of EP(P<0.05).Obesity(β=2.96,OR=2.45,95%CI=1.552-7.088)and menstruation is not clean(β=1.53,OR=2.39,95%CI=1.240-8.871)were risk factors of the malignant transformation of EP(P<0.05).Conclusion Cervical polyp,hysteromyoma and obesity are independent factors of EP.Obesity and menstruation is not clean are independent factors of EP malignant transformation.