Characteristics And Change Trends Of Endometrium In Middle-aged And Elderly Women With Abnormal Uterine Bleeding

Objective:To explore the characteristics and change trends of endometrium in middle-aged and elderly women with abnormal uterine bleeding(AUB) in the recent12years (1999.01-2010.12)Methods:From January1999to December2010,327women (aged45-89) who suffered from AUB in pre-and post-menopausal period were enrolled into this study. All of the patients underwent hysteroscopy and histopatholo diagnosis, and they were diagnosed with endometrial lesions. We divided the327cases into two groups according to the different features.(1)Grouped according to age:middle-aged group169cases (aged45-59), the elderly group158cases (aged60-89).(2)Grouped according to the the pathological diagnosis of the endometrial lesions:254cases of benign endometrial lesions,73cases of malignant endometrial lesions.(3) Grouped according to the the time stage:middle-aged group169cases(aged45-59), the elderly group158cases (aged60-89) and the previous6years group(1999.01-2004.12), the latter6years group(2005.01-2010.12)We retrospectively analyzed the endometrial characteristics of327cases and compared them between middle-aged group and elderly group. We also compared the proportions of endometrial carcinoma (EC) between the previous6years group and the latter6years group.Results:(1) In the254(77.7%,254/327) benign endometrial lesions, endometrial polyps(EP) was detected in99cases(30.3%), endometrial hyperplasia in57(17.4%), submucous myoma in57(17.4%), endometritis in41(12.6%); the other73(22.3%)cases were malignant lesions and all of them were endometrioid carcinoma(2)The main lesions included submucous myoma, endometrial hyperplasia, EP in the middle-aged group and EP, EC in the elderly group.(3) The rate of submucous myoma and endometrial hyperplasia in the middle-aged group were both significantly higher than those in the elderly group [27.8%(47/169) vs.6.3%(10/158), χ2=26.181, P=0.000and24.3%(41/169) vs.10.1%(16/158),χ2=11.334, P=0.001]; The rate of EP in the elderly group was higher than it in the middle-aged group [36.1%(57/158) vs.24.9%(42/169), χ2=4.356, P=0.037]; The rate of EC in the elderly group was significantly higher than it in the middle-aged group[31%(49/158) vs.14.2%(24/169),χ2=13.309, P=0.000].(4) The proportions of EC in the latter6years group was significantly higher than it in the previous6years group in327patients [26.4%(64/242) vs.10.6%(9/85),χ2=9.123, P=0.003)]. The rate of EC in the latter6years group was higher than it in the previous6years group in the elderly women [35.2%(44/125) vs.15.2%(5/33), χ2=4.905, P=0.027].Conclusions:The main endometrial lesions include EP and EC in postmenopausal elderly women and submucous myoma in middle-aged women. During the recent12years, the proportions of EC in elderly women is on the rise and we should pay more attention to it.