研究绝经后女性出现增生型子宫内膜并发良性子宫病变（子宫内膜息肉和子宫肌瘤）及需要未来妇科干预的长期风险，并与萎缩型子宫内膜的妇女进行比较。回顾性队列研究，纳入1997年1月至2008年12月期间年龄在55岁及以上经历子宫内膜活检的所有妇女。随访数据可追溯到2018年2月。将增生型子宫内膜的妇女与萎缩型子宫内膜的妇女进行比较，观察两组是否存在子宫内膜息肉、子宫肌瘤、复发性阴道出血的子宫内膜再活检以及子宫腔镜检查或子宫切除术的发生率。采用逻辑回归模型评估子宫内膜组织学和其他协变量与发病率的关联性。 绝经后具有增生型子宫内膜的女性更容易发展为子宫内膜息肉、子宫肌瘤并需进行手术干预。在研究期间共有1808名妇女进行了子宫内膜活检，符合纳入标准的为962名：278名为增生型，684名为萎缩型子宫内膜。两组的随访时长相似（11.9 vs 11.5年，p = 0.2）。与萎缩型子宫内膜的妇女相比，增生型子宫内膜妇女的子宫内膜息肉发生率明显较高（17.3% vs 9.7%，p = 0.001）。多变量逻辑回归分析证实，增生型子宫内膜妇女超声检测到的子宫肌瘤更多（62.1% vs 50.3%，p = 0.02），且其发生子宫内膜息肉（aOR 1.9, 95% CI 1.28-3.07，p = 0.002）、复发性子宫内膜活检（34.9%vs 16.8%，p < 0.001）以及未来的子宫切除术或子宫腔镜检查的风险增加（26.6% vs 16.2%，p <0.001）。除了长期增加患癌风险外，绝经后具有增生型子宫内膜的妇女更有可能未来出血、进行手术干预并被诊断为子宫内膜息肉。因此，在这些情况下可以考虑通过医疗管理减少雌激素活性和相关风险。版权所有© 2023. Elsevier B.V.出版。

To study the long-term risks of postmenopausal women with proliferative endometrium developing benign uterine pathologies (endometrial polyps and uterine fibroids) and requiring future gynecological interventions, and to compare them with women with atrophic endometrium.Retrospective cohort study of all women aged 55 or over who underwent endometrial biopsy between 1/1997 and 12/2008. Outcome data were available through to 2/2018. Women with proliferative endometrium were compared with those with atrophic endometrium for the presence of endometrial polyps, uterine fibroids, future endometrial biopsy for recurrent vaginal bleeding, and future hysteroscopy or hysterectomy. Logistic regression models were used to evaluate the association of endometrial histology and other covariates with the risk of morbidities.Postmenopausal women with proliferative endometrium are at higher risk of developing endometrial polyps, uterine fibroids and need for surgical intervention. Of 1808 women who underwent endometrial biopsy during the study period, 962 met inclusion criteria: 278 had proliferative and 684 had atrophic endometrium. Length of surveillance was similar in the two groups (11.9 vs. 11.5 years, p = 0.2). Compared with women with atrophic endometrium, women with proliferative endometrium had significantly higher rates of endometrial polyps (17.3 % vs 9.7 % p = 0.001). Multivariable logistic regression confirmed that women with proliferative endometrium had more fibroids on ultrasound (62.1 % vs 50.3 % 3 = 0.02), and had increased risks of developing endometrial polyps (aOR 1.9, 95 % CI 1.28-3.07, p = 0.002), repeat endometrial biopsy (34.9 % vs. 16.8%p < 0.001) and future hysterectomy or hysteroscopy (26.6 % vs 16.2 % p < 0.001).In addition to the long-term increased risk of cancer, postmenopausal women with proliferative endometrium are more likely to have future bleeding, surgical interventions and diagnosis of endometrial polyps. Medical management to reduce estrogenic activity and associated risks may be considered in these cases.Copyright © 2023. Published by Elsevier B.V.