白细胞分化抗原38、白细胞分化抗原138联合宫腔镜检查对反复胚胎移植失败病人慢性子宫内膜炎的诊断价值

Evaluating diagnostic value of the combination of hysteroscopy and histology of diagnosing chronic endometritis in repeated implantation failure patients

目的探讨白细胞分化抗原38(Cluster of Differentiation 38,CD38)、白细胞分化抗原138(Cluster of Differentiation 138,CD138)联合宫腔镜诊断反复胚胎移植失败(Repeated Implantation Failure,RIF)病人罹患慢性子宫内膜炎(Chronic Endometri⁃tis,CE)的临床价值。方法对中国科学技术大学附属第一医院2017年2月至2019年6月186例RIF病人行宫腔镜检查,获取组织标本后行CD38、CD138免疫组化染色,计算分析CE患病率及宫腔镜检查诊断的灵敏度、特异度、阳性预测值、阴性预测值等指标。结果41.40%的RIF病人诊断出组织病理学CE,宫腔镜对CE检查结果与组织病理学结果具有中度一致性(Kappa=0.553),灵敏度为94.81%,特异度为64.22%,阳性预测值为65.18%,阴性预测值为94.60%。结论在RIF病人中,采用CD38、CD138免疫组化技术联合宫腔镜检查诊断CE,可提高诊断的准确率,为CE病人的系统性治疗提供指导,值得推广。

Objective To assess the clinical value of combination of hysteroscopy and histology(CD38 and CD138)in diagnosing chronic endometritis(CE)in repeated implantation failure(RIF)patients.Methods A total of 186 patients with RIF in The First Affiliated Hospital of University of Science and Technology of China from February 2017 to June 2019 were included in this study.The combination of hysteroscopy and histology was used to diagnose CE.The prevalence of CE in the RIF patients was recorded.The sensitivity,specificity,positive predictive value and negative predictive value of hysteroscopy in diagnosing chronic endometri⁃tis were also evaluated.Results Seventy⁃seven cases(41.40%)of patients with RIF,were diagnosed as histopathological CE.The results of hysteroscopy for CE examination were moderately consistent with those of histopathology(Kappa=0.553).The sensitivity and specificity of hysteroscopy were 94.81%and 64.22%,respectively.The positive predictive value was 65.18%,and negative pre⁃dictive value was 94.60%.Conclusion Hysteroscopy combined with immunohistochemistry(CD38 and CD138)can improve the accuracy of diagnosis and provide guidance for the systemic treatment of CE patients.It is worthy of promotion.