子宫内膜癌的宫腔镜下诊断

Hysteroscopying diagnosis of carcinoma under endometrium

目的探讨子宫内膜癌的有效快捷诊断方法。方法对1999年6月￣2002年6月宫腔镜检查、内膜活检805例及确诊子宫内膜23例的宫腔镜下图像进行回顾性分析。结果宫腔镜诊断子宫内膜癌的敏感性为100%。23例子宫内膜癌中,5例为弥漫型,表现病灶凹凸不平,表面有曲张异型血管。16例为局限型,镜下表现:病灶形态不规则,有曲张异型血管的子宫赘生物。有2例表现宫腔点状出血灶,追踪检查,病理确诊子宫内膜癌。结论宫腔镜检查并行内膜组织活检、病理检查是诊断子宫内膜癌的有效快捷的方法。宫腔镜下对子宫内膜炎的诊断要慎重,对宫腔镜下的出血病灶必须追踪检查,以防子宫内膜癌的漏诊。

[Objective] To probe the quick and valid diagnosis methods of carcinoma endometrium. [Methods] Hysteroscopied from Jun 1999 to Jun. 2002. 805 cases with endometritim diopsy and 23 cases with carcinoma of endometrium has been given a retrospective analysis. [Results] The sensitivity of carcinoma of endometrium diag nosed by hysteroscopy is one hundred percent of these 23 cases 5 cases diffusing type the focus： concave or convex and heteromorphic blood vessel on the surface; 16 examples is localizing type the focus： irregular configuration and excrescence with heteromorphic blood vessel. 2 examples showed dotted hemorrhage of the endometrium, furthe examination diagnosed carcinoma of endmnetrium. [Conclusions] Hystreroscopying diopsying endometrium and patho logy examination is the quickly and validly diagnosis methods of carcinoma endometrium. Great attention must be paid to those whose focus is loose and brickle organism; circumspection must be involved when diagnosing the endometritis; further examination must be done to the hemorrhage focus in avoidance of the failure to diagnose.