三维超声联合子宫内膜采集器在子宫内膜癌筛查中的应用

Three-dimensional ultrasound combined with endometrial cell samplers in the screening of endometrial carcinoma

目的探讨三维超声联合一次性子宫内膜采集器在子宫内膜癌筛查中的价值。方法收集2018年1月至2020年12月本院108例绝经后阴道流血、异常子宫出血、阴道流液等可疑子宫内膜病变的患者。采用一次性子宫内膜采集器行子宫内膜采集,同时行细胞学和组织学检查。将结果为子宫内膜良性病变定义为阴性,子宫内膜不典型增生和子宫内膜癌定义为阳性。结果 108例患者中,6例子宫内膜取样未成功者。102例患者中良性病变者56例(54.90%),子宫内膜癌及不典型增生者46例(45.10%)。与病理学结果比较,三维超声、内膜采集器及联合检查的诊断符合率分别为88.24%(90/102)、93.14%(95/102)和97.06%(99/102)。联合检查的灵敏度、特异度、阳性预测值和阴性预测值分别为96.00%、100.00%、100.00%和96.43%。结论三维超声联合一次性子宫内膜采集器,在筛查子宫内膜癌中准确性高,并且操作较简便,是筛查子宫内膜癌的良好方法。

Objective To explore the value of three-dimensional ultrasound combined with disposable endometrial cell samplers in endometrial carcinoma screening. Methods 108 women with vaginal bleeding after menopause, abnormal uterine bleeding, vaginal discharge and other suspected symptoms from Jaunary 2018 to December 2020 in The Second Affiliated Hospital of Zhengzhou University were involved. The endometrium was collected by three-dimensional ultrasound combined with endometrial cell samplers, cytology and histology performed simultaneously. Benign endometrial lesions were defined as negative, endometrial dysplasia and endometrial carcinoma as positive. Results Among the 102 patients(excluding the successful patients who had not been brushed), 56 patients(54.90%) were pathologically diagnosed as benign lesions, 46 patients(45.10%) were diagnosed as endometrial carcinoma or atypical hyperplasia. Compared with the pathological results, the diagnostic coincidence rates of three-dimensional ultrasound, endometrial collector and combined examination were 88.24%, 93.14% and 97.06%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the combined examination were 96.00%, 100.00%, 100.00% and 96.43%, respectively.Conclusion Three-dimensional ultrasound combined with disposable endometrial cell samplers has high diagnostic accuracy and is easy to operate in the screening of endometrial carcinoma, which is expected to be an ideal screening method for endometrial carcinoma.