围绝经期子宫肌瘤病例中血清雌激素水平与子宫内膜组织学的相关性

Wael Naeem, Ahmed K.Abbas, Labiba K.Elsayed, Ahmed Goda Helal, H. Khatab, omar k.Naser, Ali A. Bendary
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摘要

背景:在受孕年龄段女性的常见肿瘤中,子宫肌瘤占 75% 以上。子宫内膜是一种激素反应性组织。子宫内膜对内源性或外源性类固醇激素的反应不足为奇,内源性反应是下丘脑-垂体-卵巢通路的一种表现。本研究的目的:评估血清 E2 水平,研究子宫肌瘤患者的子宫内膜组织学变化。患者和方法:询问病史、进行全身检查、超声波检查、测量血清雌二醇,并通过剖腹产或子宫切除术进行子宫内膜活检,以进行组织病理学检查。结果:69.2%绝经前患者的子宫内膜厚度为˃10 毫米,83%绝经后患者的子宫内膜厚度为˃5 毫米。子宫内膜增生是最常见的子宫内膜腺体病变(37.5%),无不典型性的复杂性增生占 5%,有不典型性的单纯性增生占 5%,增生性子宫占 22.5%。在绝经前患者中,伴有不典型增生的子宫内膜增生与 E2 水平(252.6 pg)的升高最为相关,伴有不典型增生的复杂增生与 E2 水平(221.6 ± 6.22 SD)相关,伴有不典型增生的子宫内膜增生与 E2 水平(184.84 ± 12.11 SD)相关,而在绝经后患者中,伴有不典型增生的子宫内膜增生与 E2 水平(245.3 pg)相关,伴有不典型增生的子宫内膜增生与 E2 水平(145.68 ± 33.53 SD)相关。结论:血清雌激素水平、子宫内膜组织病理学变化与围绝经期无症状子宫肌瘤之间存在相关性。
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Correlation between serum estrogen level and endometrial histology in cases of fibroid uterus in peri-menopausal peroid
Background: Uterine leiomyoma represents over 75% of the amiable tumours in ladies of conceptive age amass. Endometrium is a hormonally responsive tissue. The reaction of endometrium to incitement by endogenous or exogenous steroid hormones is unsurprising endogenous reaction is an impression of the hypothalamic–pituitary-ovarian pathway. Aim of this study: to assess serum level of E2 and study endometrial histological changes in instances of fibroid uterus. Patients and methods: This study included forty ladies have symptomatic fibroid uterus. history was taken, general examination, ultrasound examination, measuring serum estradiol and endometrial biopsy was taken by D&C or hysterectomy sent for histopathological examination. Results: endometrial thickness was ˃10mm in 69.2% of premenopausal and ˃5mm in 83%of postmenopausal. endometrial hyperplasia is the commonest glandular endometrial change represent (37.5%), complex hyperplasia without atypia 5%, simple hyperplasia with atypia 5% and proliferative endometrium 22.5%of all review bunch. in premenopausal patients hyperplasia with atypia related with the most elevated E2 level ( 252,6 pg) , complex hyperplasia without atypia with E2 level (221.6 ±6.22 SD), hyperplasia without atypia with E2 level (184.84 ± 12,11SD) and in postmenopausal patients hyperplasia with atypia with E2 level (245.3 pg), hyperplasia without atypia (145.68 ±33.53 SD) . Conclusion : there is correlation between serum oestrogen level , histopathological changes of endometrium and symptomatic fibroid uterus at perimenopausal age .
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