内膜厚度及绝经时间与妇女内膜癌的相关性.docVIP

内膜厚度及绝经时间与妇女内膜癌的相关性 【关键词】 内膜 【摘要】 目的 探讨经阴道超声测得的子宫内膜厚度及绝经后的时间在预测绝经后妇女阴道出血内膜癌中的作用。 方法 127例绝经后阴道出血的妇女，经阴道超声测量子宫内膜厚度后进行子宫内膜活检，无一例进行激素替代治疗。 结果 无内膜癌组内膜厚度（7.0±4.4）mm，明显低于有内膜癌组（14.3±7.3）mm，内膜厚度越厚和绝经时间越久，内膜癌的发生率越大，内膜厚度5mm内膜癌发生率为0，内膜厚度10mm内膜癌发生率为20%;绝经时间≤5年内膜癌的发生率为2.1%，绝经15年的内膜癌发生率为25.2%。 结论 结合绝经时间及子宫内膜厚度确定内膜癌活检的标准，即绝经5年、内膜厚度8mm;绝经5～15年和内膜厚度6mm;绝经时间15年和内膜厚度5mm，可不必进行内膜活检。 关键词 内膜厚度 绝经 内膜癌 绝经后出血 超声检查 Combination of endometrial thickness and time since menopause in predicting endometrial cancer in patients with postmenopausal bleeding Wang Jiagang，Ke Bin，Zhou Ruili，et al. Department of Ultrasonography，Shantou Central Hospital，Shantou515031. 【Abstract】 Objective To assess the combination of endometrial thickness measured by transvaginal sonogra-phy and time since menopause in predicting the possibility of endometrial cancer in women with postmenopausal bleed-ing.Methods The study group consisted of127women with postmenopausal bleeding who underwent sonographic measurement of endometrial thickness followed by endometrial biopsy.No women had ever received hormone replace-ment therapy.Results The mean endometrial thickness was significantly lower in absence of endometrial carcinoma（7.0±4.4）mm than in its presence（14.3±7.3）mm（P0.005）.The incidence of endometrial carcinoma in-creased with increases in endometrial thickness and the number of years since menopause.No patient had carcinoma when the endometrium was less than5mm thick，but20%did when the thickness exceeded10mm.The incidence of cancer was2.1%in women who had undergone menopause less than5years earlier but was25.2%in women who had undergone menopause more than15years prior.Conclusion Time since menopause and endometrial thickness together define cut-off points for the diagnostic biopsy of tissue samples for endometrial carcinoma;that is，within a particular time interval，biopsy should not be performed if the thickness is below a given value.When using cut-off points of6mm of endometrial thickness for women experiencin