宫腔刷取子宫内膜“有形成份”石蜡切片诊断法的临床应用价值

Clinical Application of Paraffin Section Diagnostic of Endometrial Materiality Composition Obtained by the Endometrial Sampling Device in Diagnose of Endometrial Disorders

目的探讨宫腔刷取子宫内膜"有形成份"石蜡切片诊断法对子宫内膜病变的诊断价值。方法对200例可疑子宫内膜病变患者,应用宫腔刷获取子宫内膜,先进行细胞涂片;然后将宫腔刷洗入10%福尔马林固定液中固定,对固定液中颗粒状的"有形成份"行石蜡切片组织学诊断;同时行诊断性刮宫,以诊断性刮宫的病理诊断结果作为对照,比较细胞涂片法、石蜡切片诊断法及两者联合诊断法的诊断符合率。结果子宫内膜"有形成份"石蜡切片诊断法的诊断图像背景清晰,细胞及组织结构清楚;细胞涂片、子宫内膜"有形成份"石蜡切片以及诊断性刮宫3种诊断方法的取材满意率分别为74.5%(149/200)、86.5%(173/200)、86.0%(172/200),"有形成份"与诊断性刮宫的取材满意率均高于细胞涂片组(χ2分别为9.173、8.344,P均<0.05),而两者间差异不显著(χ2=0.885,P>0.05);细胞涂片诊断法、"有形成份"石蜡切片诊断法及两者联合诊断法的诊断符合率分别为84.9%(146/172)、94.8%(163/172)、95.4%(164/172),"有形成份"石蜡切片诊断法及两者联合诊断法的诊断符合率均高于细胞涂片诊断法(P均<0.05)。结论宫腔刷取子宫内膜"有形成份"石蜡切片诊断法可作为细胞学诊断法的补充,提高宫腔刷的诊断符合率,在子宫内膜病变的诊断中具有临床应用价值。

Objective To investigate the value of paraffin section diagnostic of endometrial materiality composition ob -tained by the endometrial sampling device （ ESD） on the diagnose of endometrial disorder .Methods Using ESD to obtain endo-metrium of 200 cases of doubtful endometrial disorders ,firstly made cell smears and then rinsed the harvesters in 10%formalde-hyde solution ,separated granular endometrial materiality compositions to made paraffin sections;thereafter carried out diagnostic curettages to the same 200 cases,which diagnostic results to be compared as “Golden standard” and then compared diagnose ac-cordance rates of the two methods .Results The endometrial materiality composition paraffin section had clear background and the constitution of cells and tissue was clear ,too;of the 200 cases,149cases（74.5%,149/200） smears and 173 cases（86.5%, 173/200） endometrial materiality compositions and 172cases（86.0%,172/200） diagnostic curettages could be obtained success-fully separately,the rates of the latter two were higher than cell smears （P〈0.05）,but there was no statistic difference between the two of them （P〉0.05）;the diagnose accordance rates of smear and endometrial materiality composition and their combina -tion were 84.9%（146/172）and 94.8%（163/172）and 95.4%（164/172）separately,compared to that of the “golden stand-ard”,both the rate of the endometrial materiality composition and that of the combinational method were higher than smear method greatly （P〈0.05）.Conclusion The paraffin section diagnostic of endometrial materiality composition obtained by ESD could be supplement of smear method and further improved the diagnose accordance rate of ESD ,had application value in diagnose of endometrial disorders .