Risk Prediction Of Endometrial Hyperplasia With Endometrial Cancer

Objective: to retrospectively analyze the medical records of 203 patients with endometrial hyperplasia and to predict the risk of endometrial carcinoma complicated with endometrial hyperplasia.Methods: clinical data of patients treated with total hysterectomy in the department of obstetrics and gynecology of northern jiangsu people’s hospital for endometrial hyperplasia from January 2006 to December 2018 were collected and retrospectively analyzed.And according to the pathology after total hysterectomy,all patients were divided into endometrial cancer and endometrial hyperplasia group,compared two groups of patient’s age,menopausal status,menopause time,preoperative endometrial pathology,BMI(Body mass index),CA125(Carbohydrate antigen 125),CA199(Carbohydrate antigen 199)、 maternal time and whether maternal history,hypertension,diabetes,hysteromyoma,ovarian cyst,endometriosis,whether there is irregular vaginal bleeding,abnormal vaginal drainage,abdominal pain,preoperative endometrial thickness,preoperative endometrial based method,diagnosis to whole uterine surgery clinical features such as time,analysis of endometrial hyperplasia and endometrial cancer related risk factors.Results: 1.A total of 203 cases of patients with endometrial hyperplasia were included in this study,among which 72 cases were pathologically complicated with endometrial cancer after total hysterectomy,with a cancer rate of 35.47%.Among them,62(86.22%)were endometrial adenocarcinoma and 10(13.89%)were other types of endometrial cancer.60 patients(83.33%)were stage I,12(16.67%)were stage II,and there were no stage III or IV patients.Fifty-nine(81.94%)were highly differentiated,10(13.89%)were moderately differentiated,and 3(4.17%)were poorly differentiated,indicating that endometrial hyperplasia with endometrial carcinoma was mostly early endometrioid adenocarcinoma with good differentiation.2.The single factor analysis results show two groups of patient’s age,postmenopausal,menopause time and preoperative pathological for severe atypical endometrial hyperplasia was statistically significant difference(P <0.05),BMI,CA125,CA199,maternal time and whether maternal history,hypertension,diabetes,hysteromyoma,ovarian cyst,endometriosis,whether there is irregular vaginal bleeding,abnormal vaginal discharge fluid,abdominal pain,preoperative endometrial thickness,preoperative endometrial based method and diagnosis to the uterine surgery time differences had no statistical significance(P >0.05).3.Multiple factors analysis showed that age 53.5 years OR more(OR: 4.307,95% CI:2.018 9.192,P < 0.05),and postmenopausal(OR: 5.250,95% CI: 2.449 11.252,P < 0.05)and preoperative pathology of severe atypical endometrial hyperplasia(OR: 4.817,95%CI: 1.260 18.419,P < 0.05)difference was statistically significant(P < 0.05),while the menopause time difference has no statistical significance(P > 0.05).4.Patients with endometrial hyperplasia is not associated with risk factors and a risk factor,with two risk factors,and with three risk factors were statistically significant difference(P < 0.05),with a high risk factor with two risk factors and three risk factors were statistically significant difference(P < 0.05),but with two risk factors and there was no statistically significant difference with three risk factors(P > 0.05).Conclusion: In this study,the incidence of endometrial hyperplasia and endometrial cancer was 35.46%,much better for early differentiation of endometrial adenocarcinoma,age 53.5 years or more,postmenopausal and preoperative pathological endometrium severe dysplasia is complicated with endometrial cancer risk factors,and consolidated,the more the number of risk factors in patients with concurrent the greater the risk of endometrial cancer,should pay attention to age,menopausal status,and preoperative clinical endometrial pathological type,for preoperative diagnosis and avoid misdiagnosis.