乳腺癌术后服用他莫昔芬的绝经后子宫内膜病变的B超与宫腔镜诊治比较

Comparison between type-B ultrasonic and hysteroscopic diagnosis and treatment of endometrium lesions after menopause caused by taking tamoxifen following masteetomy

目的 回顾性分析绝经后乳腺癌术后患者接受他莫昔芬内分泌治疗的B超及宫腔镜下子宫内膜表现,以评价B超及宫腔镜对该类患者子宫内膜病变诊治的价值.方法 将本院2009年5月-2010年5月收治的40例绝经后乳腺癌术后服用他莫昔芬1年以上的患者纳入研究.所有患者均接受,并行宫腔镜直视下诊刮术,记录所有患者的结果.B超及宫腔镜检查的敏感性和特异性比较采用χ^2检验.结果 B超、宫腔镜检查诊断子宫内膜病变敏感性为80%vs95%（p=0.151）,特异性为20%vs 95%（P〈0.01）.结论 采用宫腔镜检查能更准确地判断乳腺癌术后服用他莫昔芬的绝经后患者的子宫内膜病变,以利于进一步早期治疗,提高患者生活质量.

Objective To compare the application value between B ultrasonography and hysteroscopy in the diagnosis of endometrial diseases in postmenopausal patients taking tamoxifen with postoperative breast cancer. Methods 40 postmenopausal patients with post-operative breast cancer, taking tamoxifen for 1 year or more, were included in the study. All underwent evaluation of endometrial diseases by B ultrasonographic, hysteroscopy and endometrial biopsy. The sensitivity and specificity of B ultrasonography were compared with hysteroscopy. Results The comparison of sensitivities between B ultrasonographic and hysteroscopy were 80% vs. 95% （P=0.15l）,and the specificities were 20% and 95% （P〈 0.01）, respectively, Conclusion Hysteroscopy was a more accurate method for the detection of endometrial diseases in postmenopausal patients taking tamoxifen with post-operative breast cancer than ultrasonography.