ABSTRACT
Objective:To explore the high-risk factors of endometrial cancer (EC) and provide clinical basis for early screening, diagnosis and treatment of EC.Methods:From January 2017 to December 2022, patients admitted to Shanxi Provincial Maternal and Child Health Hospital for hysteroscopic surgery or diagnostic curettage due to abnormal uterine bleeding, postmenopausal vaginal bleeding and other related symptoms were selected as the research objects. After histopathological examination, they were diagnosed with no atypical endometrial hyperplasia (EH), atypical endometrial hyperplasia (AEH), and EC as the research subjects. The general data of patients′ records, vaginal ultrasound, cervical liquid-based cytology test (LCT), carbohydrate antigen 125 (CA125) and pelvic magnetic resonance imaging were collected, and a case-control study was conducted and the risk factors of AEH and EC were explored using univariate and multivariate logistic regression analysis.Results:This study included a total of 420 cases, including 215 in the EH group, 69 in the AEH group, and 136 in the EC group. Through the comparison of various indicators among the three groups and the results of univariate factor logistic regression analysis, age, menopause, previous delivery history, hypertension, diabetes, color ultrasound showed endometrial thickening (>10 mm), uneven endometrial echo, abnormal echo mass in the uterine cavity, endometrial blood flow signals, cervical LCT examination showed that atypical glandular cells were related to the occurrence of EC, with a statistically significant difference (all P<0.05). The results of multivariate logistic regression analysis showed that age>48 years ( OR=3.65, 95% CI: 2.06-6.45), menopause ( OR=3.19, 95% CI: 1.46-6.98), uneven endometrial echo ( OR=4.08, 95% CI: 2.26-7.36), and intrauterine blood flow signal ( OR=2.91, 95% CI: 1.52-5.58), cervical LCT suggests that atypical glandular cells ( OR=4.25, 95% CI: 1.38-13.11) were independent risk factors for EC and precancerous lesions (all P<0.05). Conclusions:For patients with clinical symptoms such as abnormal uterine bleeding or postmenopausal bleeding, timely and focused screening based on whether they have EC risk factors is an economic, safe, and effective method for early detection and treatment of EC.
ABSTRACT
Objective:To investigate the effect of Fuzheng-Peiyuan recipe assisted modified VAD program on M protein, myeloma cells and immune function in patients with multiple myeloma (MM). Methods:A total of 96 patients with MM from January 2017 to May 2019 in our hospital were selected as the research objects, and they were divided into two groups according to the random number table method, with 48 patients in each group. The control group was given a modified VAD regimen (vincristine + adriamycin + dexamethasone), and the observation group was given Fuzheng-Peiyuan recipe as an auxiliary VAD regimen. Both groups were treated for 3 cycles. The clinical efficacy, TCM syndrome score, bone pain score, blood creatinine, hemoglobin, blood calcium, M protein, myeloma cells, immune function [Interleukin-2 (IL-2), Interferon-gamma (INF-γ), Interleukin-4 (IL-4), Interleukin-10 (IL-10)] levels and adverse reactions of the two groups were recorded and compared before and after treatment. Results:The total effective rate of the observation group was 81.3% (39/48), and the control group was 62.5% (30/48). The difference between the two groups was statistically significant ( χ2=4.174, P=0.041). The scores of TCM syndromes ( t=4.674, 13.328) and bone pain scores ( t=4.505, 11.398) in the observation group were significantly lower than those in the control group ( P<0.01) at 1 and 3 cycles after treatment; SCr ( t=4.452, 10.039), blood calcium ( t=4.578, 4.155) in the observation group were significantly lower than those in the control group ( P<0.01); HbAlc levels ( t=5.290, 8.871) in the observation group was significantly higher than that of the control group ( P<0.01); M protein ( t=11.145, 33.812), myeloma cells ( t=6.415, 19.731) in the observation group were significantly lower than those in the control group ( P<0.01); serum IL-2 ( t=4.922, 8.789), INF-γ ( t=5.610, 8.886) in the observation group were significantly higher than those in the control group ( P<0.01); IL-4 ( t=4.709, 6.784), IL-10 ( t=5.287, 12.823) in the observation group were significantly lower than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions in the observation group was 41.7% (20/48) and that in the control group was 62.5% (30/48). The difference between the two groups was statistically significant ( χ2=4.174, P=0.041). Conclusion:Fuzheng-Peiyuan recipe assisted in improving the VAD regimen in the treatment of MM has a significant clinical effect, which can relieve the clinical symptoms of patients and reduce the degree of bone pain, and promote the reduction of myeloma cells in patients, improve their immune function, and improve the tolerance of chemotherapy.