超声监测≤55岁乳腺癌术后患者子宫内膜及卵巢病变的临床价值

Clinical value of ultrasound in monitoring endometrial and ovarian lesions in patients with age≤55 years old after breast cancer surgery

目的探讨超声监测≤55岁乳腺癌术后患者子宫内膜及卵巢病变的临床价值。方法选取≤55岁乳腺癌术后患者148例,根据子宫内膜组织学病理结果分为良性组128例和恶性组20例,比较两组一般资料和经阴道超声检查情况。对两组差异有统计学意义的超声指标进行积分量化,分析其评估子宫内膜良恶性的价值。结果两组体质量指数、乳腺癌术后时间、恶性肿瘤家族史及是否出现临床症状比较差异均有统计学意义(均P<0.05);超声检查结果显示两组子宫内膜回声是否均匀、内膜是否存在囊性变、内膜有无息肉样变、有无宫腔积液及内膜是否存在动脉血流比较差异均有统计学意义(均P<0.05)。采用超声指标积分量化的方式评估子宫内膜恶性病变,当积分≥2分时诊断敏感性和特异性分别为70%、82%,当积分≥3分时诊断敏感性和特异性分别为40%、96%,当积分≥4分时诊断敏感性和特异性分别为53%、100%。结论超声在≤55岁乳腺癌术后患者子宫内膜及卵巢病变监测中具有较好的临床应用价值。

Objective To investigate the clinical value of ultrasound in monitoring endometrial and ovarian lesions in patients with age≤55 years old after breast cancer surgery.Methods A total of 148 patients with age≤55 years old after breast cancer surgery were selected.According to the results of endometrial histology and pathology,the patients were divided into benign group(n=128)and malignant group(n=20).The general data and transvaginal ultrasound indicators of the two groups were compared.The ultrasound indicators with significant differences in statistical results between the two groups were quantified by integral,which was used to evaluate the benign and malignant endometrium.Results There were significant differences in body mass index,time after breast cancer surgery,family history of malignant tumor and clinical symptoms between the two groups(all P<0.05).There were significant differences in endometrial echogenicity,endometrial cystic changes,endometrial flesh-free changes,endometrial effusion and endometrial arterial blood flow between the two groups(all P<0.05).The malignant lesions of endometrium were evaluated by the integration and quantification of ultrasound indicators,when the score≥2,the sensitivity and specificity were 70%and 82%,respectively.When the score≥3,the sensitivity and specificity were 40%and96%,respectively.When the score≥4,the sensitivity and specificity were 53%and 100%,respectively.Conclusion Ultrasound has good clinical application value for monitoring endometrial and ovarian lesions in pationts with age≤55 years old after breast cancer surgery.