| Objective: To investigate the pathogenesis,clinical characteristics,diagnosis and treatment of postmenopausal ovarian endometriosis cyst,providing clinical experience for the early diagnosis,individualization and standardized treatment of ovarian endometriosis cyst after menopause.Methods: Retrospective analysis was performed on the clinical and pathological data of 66 postmenopausal patients with ovarian endometriosis cyst admitted to the first hospital of jilin university from January 2010 to December 2019 and confirmed by surgery.The general condition,clinical characteristics,laboratory examination,imaging examination,treatment and prognosis were analyzed statistically.Results:(1)There were 2236 cases of ovarian endometriosis cyst in our hospital in recent 10 years,among which 66 cases were postmenopausal,accounting for 2.95%.The proportion in the last 5 years(4.00%,51/1274)was significantly higher than that in the previous 5 years(1.56%,15/962),and the difference was statistically significant(P <0.05).(2)Among the 66 patients,59(89.39%)were new-style postmenopausal ovarian endometriosis cyst,and 7(10.61%)were non-new-style.(3)Of the 66 patients,40(60.61%)had clinical symptoms,of which 37(92.5%)were associated with other diseases,the most common symptoms were abdominal pain and/or abdominal distension(47.5%)and irregular vaginal bleeding(37.5%),and 20(30.30%)had no clinical symptoms;most of them were complicated with uterine fibroids and other estrogen-related diseases.(4)There were 16 cases(45.71%)of endometrial thickness ? 5mm in overweight patients and 6 cases(21.43%)of endometrial thickness?5mm in non-overweight patients.The difference between the two was statistically significant(P <0.05).(5)All the 66 patients received surgical treatment,21(31.82%)underwent laparoscopic surgery,and 45(68.18%)underwent abdominal surgery;thirty-eight patients(57.58%)underwent total hysterectomy and bilateral salpingo-oophorectomy.(6)According to ASRM staging,among the 66 patients,34 were stage I(51.52%),5were stage II(7.58%),13 were stage III(19.70%),and 14 were stage IV(21.21%).CA125 increased in 6(15.00%)patients with non-severe EMT(stage I,II,and III),and CA125 increased in 2(20.00%)patients with severe EMT(stage IV),there was no significant difference(P >0.05).(7)There were 15 cases(50.00%)of overweight patients with endometrial pathology of non-atrophic,and 4 cases(21.05%)of non-overweight patients with endometrial pathology of non-atrophic,and the difference between the two was statistically significant(P <0.05).(8)Immunohistochemical staining was performed on the pathological tissues of 6patients(9.09%),and both ER and PR were positive.(9)56 cases were followed up,2 cases died of gynecological malignant tumor,and the remaining 54 cases were followed up so far,with no recurrence.Conclusion:(1)Postmenopausal ovarian endometriosis cyst accounts for 2.95% of all patients with ovarian endometriosis cyst,which is relatively rare in clinical practice and has an increasing proportion in recent years.(2)Postmenopausal ovarian endometriosis cyst clinical symptoms are not typical,and more associated with estrogen-related diseases.(3)For postmenopausal women,those who are overweight may have higher estrogen levels than those who are not.(4)The sensitivity of gynecologic color doppler ultrasound in the diagnosis of ovarianendometriosis cyst after menopause is relatively high,CA125 has some limitations in the diagnosis of this disease.(5)Postmenopausal ovarian endometriosis cyst is often associated with other gynecological diseases requiring surgery,total hysterectomy and bilateral salpingo-oophorectomy were more often selected. |
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