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目的分别探讨绝经前、绝经后女性子宫内膜癌(EC)发病的相关因素,为进一步防治EC提供依据。方法回顾性分析81例EC患者以及112例非EC患者,包括子宫内膜正常者56例(增生期宫内膜、分泌期宫内膜、萎缩性宫内膜),子宫内膜增生者56例(子宫内膜单纯增生、子宫内膜复杂增生、子宫内膜不典型增生),将发病年龄、初潮年龄、婚育史、体质量指数(body mass index,BMI)、高血压、糖尿病、激素替代(hormone replacement therapy,HRT)、乳腺癌术后使用他莫昔芬(tamifen,TAM)、甲状腺功能减退、多囊卵巢综合征(polycysticovariansyndrome,PCOS)、肿瘤家族史作为观察指标,通过单因素和多因素Logistic回归,分析绝经前、后EC发病的相关危险因素。结果 (1)未绝经女性:单因素分析显示高血压、PCOS、甲减、孕次、初潮年龄在2组间差异有统计学意义(P<0.05);多因素Logistic回归显示初潮年龄高、孕次多是绝经前女性EC患病的保护因素,而高血压是绝经前女性EC患病的危险因素。(2)绝经妇女:单因素分析显示BMI、孕次、初潮年龄在2组间差异有统计学意义(P<0.05);多因素Logistic回归分析显示初潮年龄高、孕次多是绝经后女性EC患病的保护因素。结论高血压是绝经前女性患EC的主要危险因素;而初潮年龄高、孕次多是绝经前及绝经后的女性EC患病的共同保护因素。
Objective To investigate the related factors of the pathogenesis of endometrial cancer (EC) in premenopausal and postmenopausal women and provide the basis for further prevention and treatment of EC. Methods A retrospective analysis of 81 cases of EC patients and 112 cases of non-EC patients, including 56 cases of normal endometrium (proliferative endometrium, secretory endometrium, atrophic endometrium), 56 cases of endometrial hyperplasia (Endometrial hyperplasia, endometrial complex hyperplasia, endometrial dysplasia), age of onset, age of menarche, age of marriage and childbirth, body mass index (BMI), hypertension, diabetes, hormone replacement Hormone replacement therapy (HRT) was used in this study. Tamoxifen (TAM), hypothyroidism, polycystic ovarian syndrome (PCOS) and family history of tumor were used as observation indicators after breast cancer surgery. Factors Logistic regression analysis of pre-menopausal and post-EC risk factors associated with EC. Results (1) In non-menopausal women, univariate analysis showed that hypertension, PCOS, hypothyroidism, gestational age and menarche age had significant difference between the two groups (P <0.05). Multivariate Logistic regression showed that age of menarche was high, Secondary is more pre-menopausal women with EC protective factors, and hypertension is a risk factor for pre-menopausal women with EC. (2) Menopausal women: Univariate analysis showed that there was significant difference in BMI, gestational age and menarche age between the two groups (P <0.05). Multivariate logistic regression analysis showed that the age of menarche was high, Preventive factors. Conclusions Hypertension is the major risk factor for EC in premenopausal women. However, the high prevalence of menarche and the multiple pregnancies are common protective factors for pre-menopausal and post-menopausal women with EC.