液基薄层细胞学联合宫腔镜在筛查子宫内膜病变中的作用

Application of ThinPrep cytology test combined with Hysteroscope in screening of endometrial lesions

目的探讨应用液基薄层制片技术将子宫内膜刷所采集到的子宫内膜细胞进行细胞学检测并联合宫腔镜检查,筛查子宫内膜病变的可行性及临床价值。方法 2012年7月至2012年12月河北省人民医院收治的因高危因素或有临床症状的500例患者,同时行子宫内膜细胞学检查和分段诊刮术,对比两种方法的取材满意率及诊断结果,对诊刮不满意的患者同时行细胞学和宫腔镜检测,并送病理,比较两种方法的诊断准确率。结果子宫内膜取样器法取材满意率为98%,诊断性刮宫术取材满意率为89%,两者取材满意率相比差异有统计学意义(P<0.05)。子宫内膜细胞学检测和宫腔镜检测在诊断结果符合率方面无统计学意义(P>0.05)。结论子宫内膜刷采集子宫内膜细胞并结合液基薄层技术进行制片,对分段诊刮不满意的细胞学可疑阳性患者进行宫腔镜的进一步检测,在筛查子宫内膜癌及其癌前病变方面是完全可行的。

Objective To evaluate the feasibility of endometrial eytopathological bush examination combined with Hystero- scope as a screening method for the diagnosis of endometrial lesions. Methods Totally 500 patients at high risk for develo- ping endometrial cancer were examined both eytopathologieal Specimens and fractional dilatation and curettage from July to December of 2012 which were compared in tissue selection and diagnosis. Taken cytopathological examination and Hystero- scope in fractional dilatation and curettage which were dissatisfied. Results Endometrial sampler method derived satisfac- tion rate of 98% ,diagnostic curettage derived satisfaction rate of 89% ,both of which derived satisfaction rate had statisti- cally significant difference （ P 〈 0. 05 ）. Hysteroseopy and endometrial cytology in the diagnosis results the rate was not sta- tistically significant （ P 〉 0. 05 ）. Conclusion ThinPrep cytology test in Endometrial cytopathologica] examination com- bined with Hysteroscope is a simple safe and reliable screening method for the diagnosis of endometrial lesions.