Abstract: Objective：This study investigated the clinical characteristics of patients diagnosed with atypical endometrial hyperplasia (AEH) and explored the risk factors of AEH upgraded to endometrial cancer (EC) after hysterectomy. Methods：159 cases of women with AEH who underwent hysterectomy during January 2015 to December 2018 in our hospital were recruited in this retrospective study. All patients were divided into two groups according to their pathological results after hysterectomy, the non-EC group (n=134, 84.3%) and the EC group (n=25, 15.7%). Results：Results showed that the incidence of obesity, menopause, abnormal blood flow signals indicated by ultrasound and diabetes were different between two groups (P＜0.05). Multivariate Logistic analysis showed that obesity (OR=3.196, 95%CI: 1.147-8.902, P=0.026) and diabetes (OR=3.866, 95%CI: 1.019-14.673, P=0.047) were independent risk factors of upgraded pathological results. Conclusions：The incidence of EC coexisted with AEH is high. For AEH patients with obesity and diabetes, comprehensive assessments and individualized treatment are needed. These high-risk patients can be overlooked until final pathology.

Key words: Endometrium, Hyperplasia, Endometrial neoplasms, Hysterectomy, Risk factors