宫腔镜对早期子宫内膜癌的诊断价值

Value of hysteroscopy in the diagnosis of early endometrial carcinoma

目的:探讨宫腔镜对早期子宫内膜癌的诊断价值。方法:将经手术病理证实无宫外转移且无绝育术史的子宫内膜癌患者71例,根据不同的术前确诊方法,分为宫腔镜组(n=31)及诊刮组(n=40),比较两组术前病理诊断与术后病理诊断的符合率;比较两种方法诊断子宫内膜癌患者宫颈受累的准确率;分析宫腔镜对腹水细胞学检查结果的影响。结果:宫腔镜组、诊刮组术前病理诊断与术后病理诊断的符合率分别为93.55%、67.50%,差异有统计学意义(χ~2=7.11,P<0.01);两组诊断宫颈受累的准确率为96.77%、77.5%,差异有统计学意义(χ~2=3.89,P<0.05);两组腹水细胞学检查阳性率为9.7%、7.5%,差异无统计学意义(χ~2=0.107,P>0.05)。结论:宫腔镜子宫内膜定位活检术对早期子宫内膜癌的诊断更有优势,且不增加子宫内膜癌患者腹腔细胞学检查的阳性风险。

Objective ：To evaluate the value of hysteroscopy in the diagnosis of early endometrial carcinoma. Methods： 71 cases of early endome- trial carcinoma were divided into the hysteroscopy group （ n = 31 ） and and the dilatation and curettage （DC） group （ n = 40） according to the differ- ent ways to diagnose the disease before the operation. The diagnostic accordance rate and the accuracy rate of cervical involvement in the patients with cndometrial carcinoma were compared between the two groups ; The influence of the hysteroscopy on the result of peritoneal cytologywas analyzed. Restilts ：The diagnostic accordance rate of the hysteroscopy group and the DC group was 93.55 % and 67.50 % respectively, the difference being signifi- cant （ χ2 = 7.11 , P 〈 0.01 ; the accuracy rate of cervical involvement of the hystemscopy group and the DC group was 96.77% and 77.5 % respec- tively, which was statistically different （χ2 = 3.89 , P 〈： 0.05 ） ; The positive rate of peritoneal cytology of the hysteroscopy group and the DC group was 9.7 % and 7.5 % respectively, the difference being insignificant （χ2 = 0. 107, P 〉0.05 ） . Condusion：Hysteroscopy is better than dilatation and curettage in the diagnosis of early endometrial carcinoma. Besides, it does not increase the risk of positive peritoneal cytology.