B超联合宫腔镜在子宫内膜癌诊断中临床研究

Clinical research on endometrial cancer diagnosed by B-ultrasound scan combined with hysteroscopy

目的探讨宫腔镜联合B超检查在子宫内膜癌诊断中的价值。方法将术前诊断子宫内膜癌并经手术治疗的35例患者分为诊刮组(17例)、宫腔镜B超组(18例),在宫腔镜下行分段诊刮术,同时B超观察宫壁厚度、宫壁回声、肌层浸润程度等。比较2组术前诊断和手术-病理分期符合率。结果诊刮组和宫腔镜B超组术前诊断与术后病理诊断符合率分别为52.9%和88.9%,2组比较有显著性差异;2组术前分期为Ⅰ期、Ⅱ期患者中,宫腔镜B超组术后经病理证实符合率分别为92.3%和100%,高于诊刮组的69.2%和75.0%,诊断符合率有显著性差异。结论 B超联合宫腔镜检查有助于提高子宫内膜癌患者术前诊断和临床分期的准确性。

Objective To explore the value of B - Ultrasound scan combined with hys- teroscopy in the diagnosis of endometrial cancer. Methods Thirty- five patients with endometrial cancer were diagnosed and the operations were performed. These patients were divided into two groups. The first group consisted of 17 patients who were diagnosed by fractional curettage, and the second group consists of 18 patients who were diagnosed by B- Ultrasound scan combined with hys- teroscopy. For the second group, ＇while the fractional curettage was being carried out with hys- teroscopy, the thickness of the uterine linings, the echo of the uterine linings and infiltration were observed. Comparison was made in the two groups regarding the pre- operation diagnosis, the op- eration, and pathologic staging coincidence rate. Results The accordance rates of the diagnosis be- fore operation and pathologic diagnosis after the operation in the first group and the second group were 52.9 % and 88.9 % respectively. There was a significant difference between the two groups. Among the patients at the stage Ⅰ ,and the stage Ⅱbefore the operation, the accordance rates of pathologic diagnosis after the operation in the second group were proved by pathology to be 92.3 % and 100%, higher than those of the first group with the rates of 69.2% and 75.0%. There was a significant difference in the diagnostic accordance rate. Conclusion Diagnosis by B - Ultrasound scan combined with hysteroscopy can help improve the accuracy of pre - operation analysis and clinical staging for the patients with endometrial cancer.