宫腔镜直视下活检及分段诊刮术与单纯分段诊刮术在子宫内膜癌诊断中的应用价值

Application Value of Biopsy and Curettage Under Hysteroscopy and Curettage in the Diagnosis of Endometrial Carcinoma

目的比较宫腔镜直视下活检及分段诊刮术与单纯分段诊刮术在子宫内膜癌诊断中的应用价值。方法选择2011年1月~2015年12月于我院行手术治疗的子宫内膜癌患者92例为观察组,选择同期于我院行手术治疗的子宫内膜癌患者142例为对照组,观察组采用宫腔镜直视下活检及分段诊刮,对照组行单纯分段诊刮。比较两组术前病理及宫颈受累情况诊断准确性。结果观察组诊断准确率为96.7%,对照组诊断准确率为86.6%,两组差异有统计学意义（P〈0.05）;观察组对宫颈受累情况诊断的敏感度、假阳性率、准确性、阴性预测值、阳性预测值依次为80.0%、0、97.8%、97.6%、100%;对照组依次为40.4%、7.6%、84.5%、87.4%、74.2%。结论宫腔镜直视下活检及分段诊刮可提高术前子宫内膜癌的病理诊断准确性及宫颈受累情况诊断准确性。

Objective To compare the value of hysteroscopy with directed biopsy and curettage or dilatation and curettage in the diagnosis of endometrial carcinoma. Methods 92 cases of endometrial carcinoma patients in our hospital from January 2011 to December 2015, were chosen as observation group, 142 cases of endometrial carcinoma patients in the same time in our hospital were chosen as control group. Observation group were diagnosed by hysteroscopy with directed biopsy and curettage and control group were diagnosed by dilatation and curettage. The diagnostic veracity of the two methods were compared. Results In the observation group, the diagnostic accurate rate was 96.7%, control group diagnosis accurate rate was 86.6%, the difference between the two groups have significant difference（P〈0.05）, observation group in the diagnosis of cervical invasion sensitivity, false positive rate, accuracy and negative predictive value, positive predictive value, followed by 80.0%, 0, 97.8%, 97.6%, 100%, followed by 40.4%, 7.6%, 84.5%, 87.4%, 74.2% in the control group. Conclusion Hysteroscopy with directed biopsy and dilatation and curettage may improve diagnostic accuracy of pathological diagnosis and cervical discoverment.