宫腔镜检查联合子宫内膜CD38、CD138水平检测对慢性子宫内膜炎的诊断价值研究

The diagnostic value of hysteroscopy combined with endometrial CD38 and CD138 levels in chronic endometritis

目的探讨宫腔镜检查联合子宫内膜CD38、CD138免疫组化检查对不孕症患者慢性子宫内膜炎(chronic endometritis,CE)的诊断价值。方法选取2018年6月至2019年6月于唐山市妇幼保健院就诊的行宫腔镜检查+诊刮的不孕症患者600例为研究对象。所有不孕症患者宫腔镜检查同时取部分子宫内膜组织进行HE染色,CD38、CD138免疫组化染色。比较宫腔镜检查、子宫内膜HE染色检查、子宫内膜CD38、CD138免疫组化检查诊断CE的发病情况,评估宫腔镜检查及CD38、CD138免疫组化检查对不孕症患者CE的诊断价值。结果不孕症患者宫腔镜检查诊断CE阳性率(24.17%)高于CD38、CD138免疫组化诊断(20%)、HE染色诊断(3%),差异有统计学意义(P<0.05)。宫腔镜检查诊断CE与CD38、CD138免疫组化检查结果有较强一致性(Kappa>0.7)。结论在不孕症患者CE的诊断中先使用宫腔镜检查了解宫腔情况,同时联合子宫内膜CD38、CD138免疫组化检查,可以提高子宫内膜炎的检出率,对CE的尽早诊断提供参考依据。

Objective To investigate the diagnostic value of hysteroscopy combined with endometrial CD38 and CD138 immunohistochemistry in patients with infertility and chronic endometritis(CE).Methods A total of 600 infertility patients undergoing hysteroscopy+endometrial curettage in Tangshan Maternal and Child Health Care Hospital from June 2018 to June 2019 were selected.All infertile patients were examined by hysteroscopy at the same time took part of the endometrial tissue for HE staining,CD38,CD138 immunohistochemical staining.The diagnosis of CE by hysteroscopy,endometrial HE staining,endometrial CD38 and CD138 immunohistochemistry was compared,and the diagnostic value of hysteroscopy and CD38 and CD138 immunohistochemistry in infertility patients was evaluated.Results The positive rate of CE diagnosis by hysteroscopy(24.17%)in infertile patients was higher than that of CD38,CD138 immunohistochemical diagnosis(20%),and HE staining diagnosis(3%),and the difference was statistically significant(P<0.05).There was a strong consistency between hysteroscopy and CD38 and CD138 immunohistochemistry in CE diagnosis(Kappa>0.7).Conclusion In the diagnosis of CE in infertile patients,hysteroscopy is used to understand the uterine cavity,and combined with endometrial CD38 and CD138 immunohistochemical examination,it can improve the detection rate of endometritis and provide a reference for the early diagnosis of CE.