两种诊断方式对子宫内膜癌腹腔冲洗液的影响

The Effect of Peritoneal Washings in Endometrial Cancer Patients by Two Kinds of Diagnostic Methods

目的:比较宫腔镜检查及分段诊刮术诊断子宫内膜癌对腹腔冲洗液阳性率的影响。方法:有腹腔冲洗液结果和完整病理检查资料的子宫内膜癌患者72例,其中宫腔镜组29例,分段诊刮组43例,在我院手术治疗,开腹后收集冲洗液后即送病理科找癌细胞。结果:腹腔冲洗液阳性者宫腔镜组有10例(34.5%),高于分段诊刮组14例(32.6%),差异无统计学意义(P<0.05);子宫内膜癌患者腹腔冲洗液阳性与病灶大小明显相关,差异有统计学意义(P<0.05);与组织学类型、浸润程度及转移等无关(P<0.05)。结论:宫腔镜有其独特优势,但仍有引起癌细胞进入腹腔的可能,若行宫腔镜检查明确子宫内膜病变时,建议膨宫压力<70mmHg,并尽量缩短检查时间。

Objective： Compared the effect of peritoneal washings in endometrial cancer patients by hysteroscope and fractional curettage. Methods： A retrospective study was carried out on 72 eases of endometrial carcinoma. Among them, 29 patients were diagnosed by hysteroscope（hysteroscope group）, 43 patients were diagnosed by fractional curettage（ fractional curettage group）, the peritoneal washings were sent for pathological diagnosis. Results：The positive per- itoneal cytology rate was 10 eases（34. 5%）in hysteroscopy group, which was higher than that in fractional cureffage group（32.6%）, but no statistical difference was found（P〉0. 05）, the positive peritoneal cytology rate was significantly correlated with tumor distribution in the uterine cavity（P〈0. 05）, but not correlated with histology type, depth of myometrial invasion and adnexal metastasis（P〈0, 05）. Conclusion： Hysteroscope has its unique advantages, but tumor cells have the potential to enter abdominal cavity, when endometrium was checked by hysteroscope, the pressure should be controlled less than 70mmHg, and the operation time should be shorten as far as possible.