Analysis of related factors affecting the diagnosis and pathological upgrading of atypical endometrial hyperplasia
ZHANG Yue-hua1 WANG Lu-yi1▲ ZHANG Se-hua2
1.Department of Pathology, Foshan First People′s Hospital in Guangdong Province, Foshan 528000, China;
2.Department of Pharmacy, Guicheng Hospital of Nanhai District in Foshan City, Guangdong Province, Foshan 528000, China
Abstract：Objective To analyze the related factors affecting the diagnosis and pathological upgrading of atypical endometrial hyperplasia (AEH).Methods The clinical data of 88 patients with AEH who were initially diagnosed in the Department of Gynecology of Foshan First People′s Hospital in Guangdong Province from December 2015 to December 2018 were retrospectively analyzed.According to the results of postoperative pathological diagnosis, the patients were divided into endometrial carcinoma (EC) group (31 cases) and AEH group (57 cases).The related factors of AEH pathological upgrading were analyzed.Results There was no significant difference in the level of high-density lipoprotein(HDL-C) and hypertension between the two groups (P＞0.05).The age and endometrial thickness of patients in the EC group were higher than those in the AEH group, and triglycerides (TG), total cholesterol (CHOL), low-density lipoprotein (LDL-C), body mass index (BMI), menopausal rate, and diabetes incidence were higher than those in AEH group,the differences were statistically significant (P＜0.05).Age≥50 years old (β=1.05, OR=2.88, 95%CI 1.11-7.62), BMI＞25 kg/m2(β=1.35, OR=3.96, 95%CI 1.27-12.66), menopausal status (β=2.72, OR=15.59, 95%CI 2.04-118.52), diabetes(β=1.62, OR=5.97, 95%CI 2.75-16.32), endometrial thickening (β=1.12, OR=3.49, 95%CI 0.76-6.33) and abnormal lipid metabolism (β=1.79, OR=6.13, 95%CI 2.04-17.92) were the risk factors of postoperative pathological progression to EC in patients with AEH (P＜0.05).Conclusion Women over 50 years old (especially in menopause), with symptoms such as abnormal uterine bleeding, dyslipidemia, endometrial thickening, obesity, diabetes and so on, have a higher probability of pathological upgrading to EC in patients with AEH.It is suggested that hysteroscopic assisted curettage should be used.If necessary, pathological examination should be frozen quickly to reduce the rate of missed diagnosis or misdiagnosis, so as to correctly diagnose and treat patients as early as possible.
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