Pipelle de Cornier~子宫内膜取样器与常规诊刮进行组织学诊断的对照研究

Comparison of Pipelle de Cornier~ sampler with conventional dilation and curettage(D&C) for endometrial biopsy

目的:评价Pipelle de Cornier子宫内膜取样器(取样器)获取子宫内膜组织进行组织学诊断的准确性。方法:收集2011年8月至11月解放军总医院妇产科需行诊断性刮宫的245例患者,行常规诊刮前用取样器先获取子宫内膜组织。由同一病理医师进行评估并作出组织学诊断。结果:(1)刮匙法的取材失败率(7.75%)与取样器法(8.98%)比较,无显著差异(P>0.05)。取材失败者主要为绝经后病例。刮匙法与取样器法的标本满意度比较,无显著差异(P>0.05)。(2)病理诊断可对比者219例,诊断符合率93.6%(205/219)。两种取材方法在子宫内膜癌、子宫内膜单纯增生、不典型增生、子宫内膜息肉、子宫内膜炎等病变中的诊断准确率均无显著差异。8例子宫内膜癌患者,两种取材方法均无漏诊。(3)取样器取材患者疼痛感显著小于刮匙组(P<0.001)。结论:Pipelle de Cornier子宫内膜取样器能够获取满意的标本用于组织学诊断,可用于大部分需常规诊断性刮宫的病例。

Objective：To investigate the feasibility of using Pipelle de Cornier sampler for endometrial biopsy. Methods： Cases of 245 patients who underwent endometrial biopsy were collected, endometrial tissues were obtained using Pipelle de Cornier sampler first. Conventional dilatation and curettage （D＆C） was also performed following the first sample collection. The specimens obtained with both methods were tested. A pathologist was assigned to assess the quality of the specimens and pathological diagnosis were made. Results： （ 1 ） The failure rates with D＆C and Pipelle de Cornier were 7.75% and 8.98% respectively（P〉0..05 ）. Sampiing failures mostly occurred in postmenopausal patients. There was no significant difference in the quality of specimen.with curette or Pipelle de Cornier. （2）219 cases qualified for comparison in pathological diagnosis using the two methods. Diagnostic coincidence was found in 205 patients, accounting for 93.6%. The sensitivity was comparable for detecting endometrial cancer, simple hyperplasia, atypical hyperplasia, endometrial polyps and endometritis. None of the 8 cases of endometrial carcinoma was missed by either methods. （3）Patients experienced less pain when Pipelle de Cornier sampler was used than when eurette was used（P〈0. 001 ）. Conclusion：Pipelle de Cornier sampler is effective in obtaining adequate endometrial tissue for pathological diagnosis. It is applicable to most of the cases in endometrial biopsy.