宫腔镜下电切术治疗子宫内膜息肉对Ki-67受体表达情况及病情复发的影响

Effect of Hysteroscopic Electrosurgical Resection for Endometrial Polyps on Ki-67 Receptor Expression and Relapse

目的:观察宫腔镜下电切术对子宫内膜息肉的治疗效果及对患者Ki-67受体表达、病情复发的影响。方法:选取2021年1月—2022年1月中牟县中医院收治的96例子宫内膜息肉患者作为研究对象。所有患者均接受宫腔镜下电切术治疗,比较入组患者治疗前后的激素水平、子宫内膜厚度及月经情况,比较两组患者术前和术后1、3、6个月时的Ki-67受体表达水平以及同期病情复发率,并通过Spearman相关性系数验证Ki-67受体表达水平与患者病情复发情况的相关性。结果:经实施宫腔镜下电切术后,患者雌二醇(E2)、促黄体生成素(LH)、卵泡雌激素(FSH)、孕酮(P)水平比较差异有统计学意义(t=4.936、7.795、7.045、6.737,P<0.05);经实施宫腔镜下电切术后,患者术后7d的子宫内膜厚度、月经量均低于术后3d,差异有统计学意义(t=4.003、5.712,P<0.05);患者术后1个月的Ki-67受体表达评分高于术后3个月、术后6个月,术后1个月的复发率高于术后3个月、术后6个月,差异有统计学意义(F=649.48;χ^(2)=11.605,P<0.05);经Spearman相关性系数检验,Ki-67受体表达水平越高,患者病情复发风险越高(r=0.325,P<0.05)。结论:Ki-67受体表达水平与子宫内膜息肉患者术后病情复发风险密切相关,及时实施宫腔镜下电切术治疗可有效控制Ki-67受体及性激素表达水平,并促进临床症状恢复,降低病情复发风险。

Objective:To observe the therapeutic effect of hysteroscopic electroresection on endometrial polyps and its impact on Ki-67 receptor expression and relapse in patients.Methods:In this study,96 patients with endometrial polyps admitted to the hospital from January 2021 to January 2022 were selected as the study subjects.All patients received hysteroscopic electrosurgical treatment.The hormone levels,endometrial thickness,and menstrual status of the enrolled patients before and after treatment were compared,and the Ki-67 receptor expression levels and relapse rates of the two groups at 1,3 and 6 months before and after surgery were compared.The correlation between the expression level of Ki-67 receptor and the relapse rate of patients through Spearman correlation coefficient were verified.Results:The levels of estradiol(E_2),luteinizing hormone(LH),follicle estrogen(FSH)and progesterone(P)were significantly different after hysteroscopic electrotomy(t=4.936,7.795,7.045,6.737;P<0.05).After hysteroscopic electrotomy,the endometrial thickness and menstrual volume of the patients 7 days after surgery were lower than 3 day after surgery,and the difference was statistically significant(t=4.003,5.712;P<0.05).Ki-67 receptor expression score 1 month after surgery was higher than that 3 months and 6 months after surgery,and the recurrence rate 1 month after surgery was higher than 3months and 6 months after surgery,with statistically significant difference(F=649.48;χ^(2)=11.605,P<0.05).According to Spearman correlation coefficient test,the higher the expression level of Ki-67 receptor was,the higher the risk of relapse in patients was(r=0.325,P<0.05).Conclusion:The expression level of Ki-67 receptor is closely related to the risk of relapse in patients with endometrial polyps after surgery.Timely implementation of hysteroscopic resection can effectively control the expression level of Ki-67receptor and sexual hormones,promote the recovery of clinical symptoms,and reduce the risk of relapse.