Monographic Research·Screening and Early Diagnosis of Gynecological Malignant Tumors
Analysis of risk factors for endometrial atypical hyperplasia and endometrial cancer
Tian Zhiping, Yao Xiue, Li Yan, Zhao Min
Published 2023-05-20
Cite as J Chin Physician, 2023, 25(5): 661-665. DOI: 10.3760/cma.j.cn431274-20230403-00436
Abstract
ObjectiveTo explore the high-risk factors of endometrial cancer (EC) and provide clinical basis for early screening, diagnosis and treatment of EC.
MethodsFrom January 2017 to December 2022, patients admitted to Shanxi Provincial Maternal and Child Health Hospital for hysteroscopic surgery or diagnostic curettage due to abnormal uterine bleeding, postmenopausal vaginal bleeding and other related symptoms were selected as the research objects. After histopathological examination, they were diagnosed with no atypical endometrial hyperplasia (EH), atypical endometrial hyperplasia (AEH), and EC as the research subjects. The general data of patients′ records, vaginal ultrasound, cervical liquid-based cytology test (LCT), carbohydrate antigen 125 (CA125) and pelvic magnetic resonance imaging were collected, and a case-control study was conducted and the risk factors of AEH and EC were explored using univariate and multivariate logistic regression analysis.
ResultsThis study included a total of 420 cases, including 215 in the EH group, 69 in the AEH group, and 136 in the EC group. Through the comparison of various indicators among the three groups and the results of univariate factor logistic regression analysis, age, menopause, previous delivery history, hypertension, diabetes, color ultrasound showed endometrial thickening (>10 mm), uneven endometrial echo, abnormal echo mass in the uterine cavity, endometrial blood flow signals, cervical LCT examination showed that atypical glandular cells were related to the occurrence of EC, with a statistically significant difference (all P<0.05). The results of multivariate logistic regression analysis showed that age>48 years (OR=3.65, 95% CI: 2.06-6.45), menopause (OR=3.19, 95% CI: 1.46-6.98), uneven endometrial echo (OR=4.08, 95% CI: 2.26-7.36), and intrauterine blood flow signal (OR=2.91, 95% CI: 1.52-5.58), cervical LCT suggests that atypical glandular cells (OR=4.25, 95% CI: 1.38-13.11) were independent risk factors for EC and precancerous lesions (all P<0.05).
ConclusionsFor patients with clinical symptoms such as abnormal uterine bleeding or postmenopausal bleeding, timely and focused screening based on whether they have EC risk factors is an economic, safe, and effective method for early detection and treatment of EC.
Key words:
Endometrial neoplasms; Endometrial hyperplasia; Risk factors
Contributor Information
Tian Zhiping
Shanxi Medical University, Taiyuan 030000, China
Yao Xiue
Department of Gynecology, Shanxi Provincial Maternal and Child Health Hospital, Taiyuan 030000, China
Li Yan
Department of Gynecology, Shanxi Provincial Maternal and Child Health Hospital, Taiyuan 030000, China
Zhao Min
Department of Gynecology, Shanxi Provincial Maternal and Child Health Hospital, Taiyuan 030000, China
