Study On The Changes Of Endometrium And The Strategies For Observation During Continuous-combined Hormone Replacement Therapy

[Objective]1. To compare various methods of endometrial biopsy and to explore the property and accuracy of pipe sampling endometrial biopsy.2. To observe the endometrium with TVS, cytopathology and histopathology and to search for the clinical application of pipe sampling endometrial biopsy in HRT.3. To observe the changes of endometrium during continuous-combined HRT in different regime, dosage and duration for prevention of postmenopausal bone loss, to explore the value of cytopathology in the evaluation of endometrium, the selection of regimen and the individual therapy during HRT.4. To explore the endometrial proliferation, apoptosis and inhibition during continuous-combined HRT with Ki67, Bcl-2 and M30.5. To detect the change of IGF-I and IGFBP-I in endometrium and blood, to evaluate the value of IGFBP-1 in selection of the proper progestin in continuous-combined HRT.[Methods]1. A randomized prospective study was designed. The histopathological examination of endometrium was performed by the same pathologist using single-blinded method. Comparsions were made between pipe sampling and 31 cases who had hysterectomy, 33 cases had hysteroscopy and 16 cases had D&C respectively.2. A retrospective analysis was carried out in 412 cases in which the endometrial biopsy were conducted by pipe sampling having pathology report from August, 1999 to May, 2003. The demographic characteristics and the other parameters were recorded such as age, age of menopause, years after menopause, menstruation, history of HRT, reasons for endometrial biopsy and the date of operation. The endometrial thickness measured by TVS, the amount of tissue sampled, insepction of endometrial tissue by eye, the...