通过比较绝经后无症状子宫内膜增厚患者的宫腔镜与病理结果，探讨宫腔镜在绝经后无症状子宫内膜增厚患者的诊治意义。

回顾性分析2019年1月1日至2021年12月31日在首都医科大学附属复兴医院收治的126例绝经后无症状子宫内膜增厚患者，实施宫腔镜检查和/或宫腔镜下手术治疗的临床资料。首先通过Fisher精确检验比较患者宫腔镜镜下诊断与术后病理结果的一致性，探索宫腔镜诊断对于绝经后无症状子宫内膜增厚患者临床诊断的准确性；进一步通过绘制受试者工作特征（ROC）曲线，探寻超声测量的子宫内膜厚度对绝经后无症状子宫内膜增厚患者罹患子宫内膜恶性疾病的预测价值。

宫腔镜检查结果显示，126例患者中子宫内膜息肉78例（61.9%），子宫黏膜下肌瘤12例（9.5%），萎缩性子宫内膜15例（11.9%），子宫内膜增生12例（9.5%），子宫内膜非典型增生4例（3.3%），子宫内膜癌5例（3.9%）。126例患者的送检标本的病理结果显示，子宫内膜息肉73例（57.9%），子宫黏膜下肌瘤12例（9.5%），萎缩性子宫内膜15例（11.9%），子宫内膜增生17例（13.5%），子宫内膜非典型增生3例（2.4%），子宫内膜癌6例（4.8%）。宫腔镜检查与病理诊断结果的总体一致率为95.2%，二者存在相关性（P＜0.05）。ROC曲线显示，子宫内膜厚度预测子宫内膜恶性疾病（包括非典型增生和子宫内膜癌）的曲线下面积为0.752，当内膜厚度阈值为11.5 mm时，预测子宫内膜恶性疾病的灵敏度和特异度分别为66.7%和75.2%。

绝经后无症状的子宫内膜增厚患者，实施宫腔镜检查和/或宫腔镜手术，可以精准诊断、有效治疗；当患者子宫内膜厚度＞11.5 mm时更易罹患子宫内膜恶性疾病。

To explore the clinical significance of hysteroscopy in the diagnosis and treatment of postmenopausal women with asymptomatic endometrial thickening.

A total of 126 postmenopausal women with asymptomatic endometrial thickening, who underwent hysteroscopic and/or surgical treatment at Capital Medical University Fuxing Hospital from January 1, 2019 to December 31, 2021, were retrospectively analyzed. The Fisher's exact test was used to compare the consistency between the hysteroscopic diagnosis and postoperative pathological results to explore the accuracy of hysteroscopy in the clinical diagnosis of postmenopausal patients with asymptomatic endometrial thickening. Receiver operating characteristic (ROC) curve analysis was performed to explore the value of endometrial thickness measured by ultrasound in predicting endometrial malignant disease.

Hysteroscopy showed that among the 126 patients, 78 (61.9%) had endometrial polyps, 12 (9.5%) had uterine mucosal submucosal fibroids, 15 (11.9%) had atrophic endometrium, 12 (9.5%) had uterine endometrial hyperplasia, 4 (3.3%) had atypical endometrial hyperplasia, and 5 (3.9%) had endometrial carcinoma. The pathological results of the submitted specimens from 126 patients showed 73 (57.9%) cases of middle endometrial polyps, 12 (9.5%) cases of uterine mucosal submucosal fibroids, 15 (11.9%) cases of atrophic endometrium, 17 (13.5%) cases of intrauterine membrane hyperplasia, 3 (2.4%) cases of atypical endometrial hyperplasia, and 6 (4.8%) cases of endometrial carcinoma. The overall consistency rate between hysteroscopy and pathological diagnosis was 95.2%, and the two were significantly correlated (P＜0.05). ROC curve analysis showed that the area under the curve of endometrial thickness for predicting endometrial malignancy (including atypical hyperplasia and endometrial cancer) was 0.752. When the endometrial thickness cut-off value was 11.5 mm, the sensitivity and specificity were 66.7% and 75.2%, respectively.

Postmenopausal patients with asymptomatic endometrial thickening can undergo hysteroscopy and/or hysteroscopic surgery for accurate diagnosis and effective treatment; patients with endometrial thickness＞11.5 mm are more likely to suffer from intrauterine disease.