术前子宫内膜癌分段诊刮和B超诊断

Value of Preoperative Fractional Curettage and B-ultrasonography for Endometrial Carcinoma

目的 :评估分段诊刮和B超诊断子宫肌层受侵在处理子宫内膜癌中的价值。方法 :对 2 10例子宫内膜癌术前分段诊刮标本和术后子宫切除标本行病理检查并进行比较分析 ,同时B超检查子宫肌层受侵情况与术后病理对照。结果 :分段诊刮 2 10例中 16 2例临床诊断宫颈受侵 ,术后病理证实其中的 12 4例受侵。临床诊断符合率76 .5 4 % ,假阳性率 2 3.4 6 %。B超显示肌层受侵 4 8例 ,术后病理证实 4 6例 ,符合率 95 .83%。结论 :分段诊刮有局限性。必要时术中冰冻切片予以纠正。B超诊断子宫内膜癌肌层受侵 ,准确率高 ,经济、实用。术前制定子宫内膜癌治疗方案 ,特别是拟行腹膜后淋巴结清扫时 。

Objective:To assess the value of fractional curettage and B-ultrasonography in diagnosing endometrial carcinoma with myometrial invasion.Methods:210 cases of endometrial carcinoma were given preoperative fractional curettage and B-ultrasonography,and the results were analysed and compared with postoperative samples by histopathology.Results:124 of the 162 cases with positive fractional curettage in 210 were proven of cervical invasion by histopathology.False positive rate was 23.46%.Of the 48 cases diagnosed as myometrial invasion by B-ultrasonography,46 were confirmed by histopathology.The accurate rate was 95.83%.Conclusions:(1)The fractional curettage has some limitions,and if necessary we should apply frozen section intraoperatively.(2)B-ultrasonography is highly accurate in diagnosis of myometrial invasion.(3)During therapy of endometrial carcinoma,especially when the retroperitoneal lymphatic hodes are to be resected,it is rational to use boths B-ultrasonography and fractional curettage before operation.