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目的:探讨子宫内膜不典型增生(AEH)的临床特点和影响诊断的相关因素。方法:回顾性分析广西医科大学第一附属医院77例术前诊断为AEH患者的临床病理资料,根据术后病理诊断分为子宫内膜癌组(A组,50例)和AEH组(B组,27例)进行比较分析。结果:A组全部为子宫内膜样腺癌,占64.9%,B组占35.1%;两组年龄比较,t=2.708,P=0.008<0.05,差异有统计学意义;术后病理诊断与术前诊刮AEH的分度有关,轻、中、重度AEH合并子宫内膜癌率分别为28.6%、42.1%、78.4%;两组肿瘤标记物CA125比较,P=0.140>0.05,差异无统计学意义。结论:①年龄是AEH合并子宫内膜癌的高危因素;②随着诊刮AEH分度增加,合并子宫内膜癌有增加趋势;合并子宫内膜癌多数分化较好、浸润少、期别以Ⅰ期为主。③血清CA125不是预测AEH合并子宫内膜癌的敏感指标。
Objective: To investigate the clinical features of endometrial dysplasia (AEH) and the related factors that affect the diagnosis. Methods: The clinicopathological data of 77 patients with AEH preoperatively diagnosed in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. According to the postoperative pathological diagnosis, they were divided into three groups: endometrial cancer group (50 cases) and AEH group (B group) , 27 cases) for comparative analysis. Results: A group of all endometrioid adenocarcinoma, accounting for 64.9%, B group accounted for 35.1%; two groups of age, t = 2.708, P = 0.008 <0.05, the difference was statistically significant; postoperative pathological diagnosis and surgery The rate of AEH with preeclampsia was 28.6%, 42.1% and 78.4%, respectively. There was no significant difference in CA125 between two groups (P = 0.140> 0.05) significance. Conclusions: ① Age is a risk factor for AEH complicated with endometrial cancer; ②With the increase of AEH index, the incidence of endometrial cancer has an increasing trend; the majority of patients with advanced endometrial carcinoma have better differentiation and less infiltration, Ⅰ-based. ③ serum CA125 is not a sensitive indicator of predicting AEH with endometrial cancer.