[1]周伟伟,葛小花.子宫内膜息肉复发因素分析及预测模型建立[J].医学信息,2025,38(08):92-95,117.[doi:10.3969/j.issn.1006-1959.2025.08.018]
　ZHOU Weiwei,GE Xiaohua.Analysis of Recurrence Factors of Endometrial Polyps and Establishment of Prediction Model[J].Journal of Medical Information,2025,38(08):92-95,117.[doi:10.3969/j.issn.1006-1959.2025.08.018]
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子宫内膜息肉复发因素分析及预测模型建立()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年08期
页码:
92-95,117
栏目:
论著
出版日期:
2025-04-15

文章信息/Info

Title:
Analysis of Recurrence Factors of Endometrial Polyps and Establishment of Prediction Model
文章编号:
1006-1959（2025）08-0092-05
作者:
周伟伟; 葛小花
安徽医科大学附属巢湖医院妇产科，安徽 巢湖 238000
Author(s):
ZHOU Weiwei;  GE Xiaohua
Department of Obstetrics and Gynecology, Chaohu Hospital of Anhui University, Chaohu 238000, Anhui, China
关键词:
子宫内膜息肉; 复发危险因素; 森林图; 预测模型
Keywords:
Endometrial polyp;  Risk factors for recurrence;  Forest map;  Prediction model
分类号:
R711.32
DOI:
10.3969/j.issn.1006-1959.2025.08.018
文献标志码:
A
摘要:
目的 探讨基于森林图构建的子宫内膜息肉（EP）复发危险因素预警模型的预测价值。方法 选取2022年1月-2023年1月安徽医科大学附属巢湖医院收治的98例接受宫腔镜下子宫内膜息肉切除术（TCRP）后的患者进行随访，根据术后情况分为复发组和未复发组。应用Logistic分析患者术后复发的危险因素，构建复发预警模型，分析模型的预测价值。结果 单因素结果显示，年龄≥40岁、体重指数≥28 kg/m2、合并子宫肌瘤、术后未处理是EP患者术后复发的影响因素（P＜0.05）；多因素 Logistic 显示，体重指数≥28 kg/m2、合并子宫肌瘤、术后未应用孕激素类药物是EP复发的独立危险因素（P＜0.05）；术后使用孕激素及曼月乐环是TCRP后复发的独立保护因素；森林图显示体重指数≥28 kg/m2、合并子宫肌瘤、术后未处理均为正相关危险因素，与无效线不相交（P＜0.05）；以森林图为基准构建风险预警模型，经Hosmer-Lemeshow拟合优度检验，模型拟合效果良好，受试者工作特征（ROC）曲线显示，AUC 为0.887（95%CI：0.808~0.967），敏感度为 73.80%，特异度为 92.90%。结论 基于森林图构建的子宫内膜息肉复发危险因素预警模型具有良好的预测价值，能为临床及早采取针对性预防复发措施提供可靠依据。
Abstract:
Objective To explore the predictive value of early warning model of risk factors for recurrence of endometrial polyps (EP) based on forest map. Methods A total of 98 patients who underwent transcervical polyp resection (TCRP) in Chaohu Hospital of Anhui Medical University from January 2022 to January 2023 were selected for follow-up. According to the postoperative conditions, they were divided into recurrence group and non-recurrence group. Logistic analysis was used to analyze the risk factors of postoperative recurrence, and a recurrence warning model was constructed to analyze the predictive value of the model. Results Univariate results showed that age ≥40 years old, body mass index ≥28 kg/m2, combined with uterine fibroids, and postoperative untreated were the influencing factors of postoperative recurrence in EP patients (P<0.05). Multivariate Logistic analysis showed that body mass index ≥28 kg/m2, uterine fibroids, and no use of progesterone drugs after surgery were independent risk factors for EP recurrence (P<0.05). Postoperative use of progesterone and Mirena ring were independent protective factors for recurrence after TCRP. The forest map showed that body mass index ≥ 28 kg/m2, uterine fibroids, and postoperative untreated were all positively correlated risk factors, which did not intersect with the invalid line (P<0.05). The risk early warning model was constructed based on the forest map. The Hosmer-Lemeshow goodness of fit test showed that the model had a good fitting effect. The receiver operating characteristic (ROC) curve showed that the AUC was 0.887 (95%CI: 0.808-0.967), the sensitivity was 73.80%, and the specificity was 92.90%. Conclusion The early warning model of risk factors for recurrence of endometrial polyps based on forest map has good predictive value, which can provide a reliable basis for clinical early targeted prevention and recurrence measures.

参考文献/References:

[1]Nijkang NP,Anderson L,Markham R,et al.Endometrial polyps: Pathogenesis, sequelae and treatment[J].SAGE Open Med,2019,7:2050312119848247.[2]Wang X,Zhang H,Xu J,et al.The typical polypoid adenomyoma is a special form of endometrial polyp: a case-controlled study with a large sample size[J].Eur J Med Res,2023,28(1):308.[3]田文艳,张慧英,薛凤霞.子宫内膜息肉诊治中国专家共识(2022年版)解读[J].实用妇产科杂志,2023,39(1):29-33.[4]Wang Y,Yang M,Huang X,et al.Prevention of Benign Endometrial Polyp Recurrence Using a Levonorgestrel-releasing Intrauterine System in Premenopausal Patients:A Retrospective Cohort Study[J].Journal of Minimally Invasive Gynecology,2020,27(6):1281-1286.[5]Ceci O,Franchini M,Cardinale S,et al.Comparison of endometrial polyp recurrence in fertile women after office hysteroscopic endometrial polypectomy using two widely spread techniques[J].Journal of Obstetrics and Gynaecology Research,2020,46(10):2084-2091.[6]Yang JH,Chen CD,Chen SU,et al.Factors Influencing the Recurrence Potential of Benign Endometrial Polyps after Hysteroscopic Polypectomy[J].PLoS One,2015,10(12):e0144857.[7]Carlson L,Flores Poccia V,Sun BZ,et al.Early breast development in overweight girls: does estrogen made by adipose tissue play a role?[J].Int J Obes (Lond),2019,43(10):1978-1987.[8]Hetem?覿ki N,Savolainen-Peltonen H,Tikkanen MJ,et al.Estrogen Metabolism in Abdominal Subcutaneous and Visceral Adipose Tissue in Postmenopausal Women[J].Journal of Clinical Endocrinology & Metabolism,2017,102(12):4588-4595..[9]Reavey JJ,Walker C,Murray AA,et al.Obesity is associated with heavy menstruation that may be due to delayed endometrial repair[J].Journal of Endocrinology,2021,249(2):71-82.[10]Salcedo AC,Yun JE,Carter C,et al.Therapeutic Carbohydrate Restriction as a Metabolic Modality for the Prevention and Treatment of Abnormal Uterine Bleeding[J].Nutrients,2023,15(17):3760.[11]Rotenberg O,Doulaveris G,Fridman D,et al.Risk of endometrial polyp and surgical intervention in postmenopausal women with proliferative endometrium[J].Maturitas,2023,178:107847.[12]K?覦nay T,?魻ztürk Basar?覦 Z,F?覦rt?覦na Tuncer S,et al.Prevalence of endometrial polyps coexisting with uterine fibroids and associated factors[J].Turk J Obstet Gynecol,2016,13(1):31-36.[13]Rshoud FA,Omari BA,Qudsi A,et al.Polycystic ovarian syndrome - association and risk factors between endometrial polyp and infertility. A retrospective study[J].Prz Menopauzalny,2022,21(2):106-110.[14]李淑娟,王爱芹,杨学军.子宫内膜息肉发病相关危险因素临床分析[J].医学信息,2019,32(13):119-122.[15]Feng MN,Zhang TM,Ma HP.Progesterone ameliorates the endometrial polyp by modulating the signaling pathway of Wnt and -catenin via regulating the expression of H19 and miR-152[J].Journal of Cellular Biochemistry,2019,120(6):10164-10174.[16]Su Y,Feng W,Shi H.Treatment with progesterone attenuates proliferation of endometrial polyps (EP) via regulation of expression of miR-320b and its target gene, MCL1[J].Archives of Medical Science,2023,19(6):1934-1939.[17]Walter KR,Balko JM,Hagan CR.Progesterone receptor promotes degradation of STAT2 to inhibit the interferon response in breast cancer[J].OncoImmunology,2020,9(1):1758547.[18]Chowdary P,Maher P,Ma T,et al.The Role of the Mirena Intrauterine Device in the Management of Endometrial Polyps:A Pilot Study[J].Journal of Minimally Invasive Gynecology,2019,26(7):1297-1302.[19]刘菊红,唐世倩,褚春芳.宫腔镜电切术联合曼月乐环治疗复发性子宫内膜息肉的效果分析[J].解放军预防医学杂志,2019,37(7):63-65.[20]韩晓洁,万颖.宫腔镜下子宫内膜息肉切除术后两种不同方法预防息肉复发的效果比较[J].中国妇产科临床杂志,2020,21(4):422-424.

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更新日期/Last Update: 1900-01-01