论文部分内容阅读
目的探讨武汉市子宫内膜癌及癌前病变的危险因素。方法选取2012年3月-2015年3月武汉市接受宫腔镜+诊刮术+子宫内膜细胞学检查的女性678例作为研究对象,对比子宫内膜细胞学检查和组织病理学检测的结果。应用Logistic回归分析影响子宫内膜细胞学和组织病理学诊断结果的相关因素。结果子宫内膜细胞学诊断结果显示,子宫内膜癌56例(8.5%)、子宫内膜非典型性增生82例(12.4%);组织病理学诊断结果显示,子宫内膜癌52例(8.2%)、子宫内膜非典型性增生79例(12.4%);诊断结果基本相同。Logistic回归分析发现,子宫内膜细胞学诊断中子宫内膜癌及癌前病变的危险因素为绝经、糖尿病、家族恶性肿瘤史、高血压、年龄≥40岁和体重指数≥23 kg/m~2,独立危险因素为年龄≥40岁、体重指数≥23 kg/m~2。Logistic回归分析发现,组织病理学诊断中子宫内膜癌及癌前病变的危险因素为绝经、糖尿病、家族恶性肿瘤史、高血压、年龄≥40岁、体重指数≥25 kg/m~2及接触过毒性放射线,独立危险因素为糖尿病、家族恶性肿瘤史、年龄≥40岁及体重指数≥25 kg/m~2。结论与组织病理学检测方法相比,子宫内膜细胞学检查在子宫内膜癌及癌前病变的筛查中均具有更高的应用价值。有家族恶性肿瘤史、体重指数偏高、患有糖尿病与高血压等慢性疾病、年龄≥40岁的女性需要定时进行子宫内膜癌及癌前病变的筛查工作,子宫内膜细胞学和组织病理学诊断的相关危险因素相差不大。
Objective To investigate the risk factors of endometrial cancer and precancerous lesions in Wuhan. Methods A total of 678 women who underwent hysteroscopy + curettage + endometrial cytology in Wuhan from March 2012 to March 2015 were selected as the study subjects, and the results of endometrial cytology and histopathology were compared . Logistic regression analysis was used to analyze the factors influencing endometrial cytology and histopathological diagnosis. Results Endometrial cytology showed that endometrial cancer in 56 cases (8.5%), endometrial atypical hyperplasia in 82 cases (12.4%); histopathological diagnosis showed that 52 cases of endometrial cancer (8.2 %), Atypical endometrial hyperplasia in 79 cases (12.4%); the diagnostic results are basically the same. Logistic regression analysis found that endometrial cytology and endometrial cancer precancerous lesions risk factors for menopause, diabetes, family history of malignancy, hypertension, age ≥ 40 years old and body mass index ≥ 23 kg / m ~ 2 , Independent risk factors for age ≥ 40 years old, body mass index ≥ 23 kg / m ~ 2. Logistic regression analysis found that the risk factors of endometrial cancer and precancerous lesions in histopathological diagnosis were menopause, diabetes, family history of malignancy, hypertension, age ≥40 years, body mass index ≥25 kg / m ~ 2 and exposure Toxic radiation, independent risk factors for diabetes, family history of malignancy, age ≥ 40 years old and body mass index ≥ 25 kg / m ~ 2. Conclusion Compared with histopathological examination, endometrial cytology has a higher value in the screening of endometrial cancer and precancerous lesions. A family history of malignant tumors, high body mass index, suffering from chronic diseases such as diabetes and hypertension, age ≥ 40-year-old women need regular screening for endometrial cancer and precancerous lesions, endometrial cytology and tissue Pathological diagnosis of the relevant risk factors or less.