宫腔镜辅助分段诊刮在子宫内膜癌患者术前诊断中的作用

Effect of hysteroscope assist fractional curettage on preoperative diagnosis of patients with endometrial cancer

目的探讨宫腔镜辅助分段诊刮在子宫内膜癌术前诊断的应用价值。方法回顾性分析2010年7月至2014年12月经手术及病理检查确诊的126例子宫内膜癌患者的临床资料，对两种分段诊刮方法在子宫内膜癌术前诊断中的效果进行比较。结果与术后病理诊断结果比较，观察组术前诊刮诊断符合率为91．9％，对照组符合率为59．4％，组间比较差异有统计学意义（P〈0．05）。观察组术前病理分期与术后临床分期符合率为91．9％，对照组为73．4％，组间比较差异有统计学意义（P〈0．05）。腹腔冲洗液脱落细胞学检查：观察组阳性率为12．9％，对照组为10．9％，组间比较差异未见统计学意义（P〉0．05）。结论宫腔镜辅助分段诊刮术用于子宫内膜癌患者的术前诊断，可有效提高术前诊刮诊断符合率及与术后临床分期的符合率，且腹腔冲洗液脱落细胞学检查阳性率无明显提高，临床应用安全，效果确切。

Objective To investigate the application value of hysteroscope assist fractional curettage on preoperative diagnosis of patients with endometrial cancer. Methods Retrospectively analyzed the clinical data of 126 patients, who made a definite diagnosis through operation and pathological exami- nation from July 2010 to December 2014, the effects of the two types of fractional curettage on preopera- tive diagnosis of endometrial cancer were compared. Results Compared with pathological diagnosis after the operation, the curettage diagnose accordance rate of observation group was 91.9% before the opera- tion and that of control group was 59.4%, there was significant difference between the two groups（P 〈 0. 05 ）. Pathological stage before the operation and clinical stages after the operation of observation group was 91.9% and that of control group was 73.4%, there was significant difference between the two groups （P 〈 0. 05）. Examined by peritoneal wash exfoliocytology, positive rate of the observation group was 12. 9% and that of control group was 10. 9%, there was no significant difference between the two groups （P 〉 0. 05）. Conclusions Hysteroscope assist fractional curettage on preoperative diagnosis of endometrial cancer can enhance the accordance rate of curettage diagnosis before the operation and clinical stages after the operation, the positive rate of peritoneal wash exfolioeytology examination with no obvious inereasement, the clinical application is safe and effect is definite.