子宫内膜癌筛查的临床方法比较

Comparative analysis of clinical methods for endometrial carcinoma screening

目的探讨Pipelle内膜取样器和Tao Brush内膜采样器在子宫内膜癌(EC)筛查中的诊断价值比较。方法随机选取2015年7月至2017年7月间在深圳市第二人民医院妇科收治拟行诊刮术的200例患者,分入Tao刷组和Pipelle吸管组各100例,分别用Tao Brush内膜采样器和Pipelle内膜取样器进行子宫内膜取样,然后行诊刮术,均行液基细胞学分析和组织病理学分析,比较两种内膜取样器的病理诊断符合率,以两组取材满意度、疼痛评分(VAS)、出血量、患者的依从性作为评价指标。结果 Pipelle内膜取样器和Tao Brush内膜采样器在出血量和疼痛程度、并发症、依从性上无统计学差异(P>0.05);Tao Brush内膜采样器和Pipelle内膜取样器与病理诊断的符合率均为98%,敏感度分别为95.0%和93.1%,特异度分别为96.0%和93.9%,阳性预测值96.0%和93.0%,阴性预测值95.0%和93.0%;在控制相关因素下,Tao Brush内膜采样器和Pipelle内膜取样器相比刮诊的符合率无统计学差异(P>0.05)。结论两种方法均可用于子宫内膜癌的筛查,但Tao Brush价格和诊断价值优于Pipelle吸管,可为作为首选。

Objectives To compare the diagnostic value of Pipelle endometrial sampler and Taobrush endometrial sampler in endometrial cancer screening. Method 200 patients with abnormaluterine bleeding had endometrial sampling with randomly either Pipelle,or Tao brush sampler,werecompared with DC as gold standard,in the department of Obstetrics and Gynecology Unit,the SecondHospital of Shen Zhen,China,during the period of July 2015-July,2017. Pain score（VAS）,bleedingvolume,adequacy of samples and patient. s compliance were also compared between the two groups.Results There was no significantly difference in the diagnostic accuracy between two groups（P〉0.05）,with a correlations of both 98% compared with DC; and the patients. factors in bleeding volume,VAS,sample adequacy and complications were matched with no statistic significance（P〉0.05）.Respectively,the sensitivity and specificity of two groups was 95.0%,93.1%,96.0% and 93.9%respectively;and the positive predictive value and the negative predictive value was 96.0%,93.0%,95.0% and 93.0%,respectively in each group. It.s indicated that there is no significant difference inaccuracy between Tao brush and Pipelle biopsy compared with DG as gold standard in diagnosing（P〉0.05）. Conclusion It is concluded that both Tao brush and Pipelle biopsy are useful and cost-effectivesampler methods compared with DC,whist Tao brush perhaps has higher accuracy by taking biopsy forthe patient thereby for early diagnosis of malignancy.