经阴道彩色多普勒超声诊断子宫内膜癌Ⅰ期肌层浸润程度的效果

Efficacy of transvaginal color ultrasound in the diagnosis of degree of myometrial tumor invasion in stageⅠendometrial carcinoma

目的探讨经阴道彩色多普勒超声诊断子宫内膜癌Ⅰ期肌层浸润程度的应用效果。方法选取2015年5月至2018年5月间上海市金山区亭林医院收治的72例子宫内膜癌Ⅰ期患者,采用彩色多普勒超声诊断仪对患者肌层浸润程度进行诊断。结果肌层浸润程度> 1/2患者的子宫内膜厚度高于肌层浸润程度≤1/2;随着组织学分级的提升,肌层浸润程度> 1/2患者比例逐渐提升,肌层浸润程度≤1/2患者比例逐渐降低;有淋巴结转移患者的肌层浸润程度> 1/2比例高于无淋巴结转移患者,肌层浸润程度≤1/2比例低于无淋巴结转移患者,差异均有统计学意义,(均P <0. 05)。不同绝经情况和病理类型患者的肌层浸润程度> 1/2和肌层浸润程度≤1/2比例,差异无统计学意义(P> 0. 05)。经阴道彩色多普勒超声诊断子宫内膜癌Ⅰ期肌层浸润程度的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为84. 0%、89. 4%、87. 5%、80. 8%和91. 3%。经阴道彩色多普勒超声和病理诊断子宫内膜癌Ⅰ期的一致率和Kappa值分别为72. 2%和0. 580。结论经阴道彩色多普勒超声在诊断子宫内膜癌Ⅰ期肌层浸润程度中的应用效果好,值得推广。

Objective To explore the efficacy of transvaginal color ultrasound in the diagnosis of degree of myometrial tumor invasion in stageⅠendometrial carcinoma.Methods A total of 72 patients with endometrial stageⅠendometrial carcinoma treated at Shanghai Jinshan District Tinglin Hospital from May 2015 to May 2018 were selected and analyzed.Transvaginal color Doppler ultrasound was used to detect the degree of myometrial tumor invasion.Results The endometrial thickness was significantly higher in patients with myometrial invasion degree>1/2 than in patients with myometrial invasion degree≥1/2(P<0.05).With the increase of histological grade,the proportions of patients with myometrial infiltration≥1/2 gradually increased(P<0.05),and the proportions of patients with myometrial invasion degree<1/2 decreased(P<0.05).The rate of infiltration degree≥1/2 was higher in patients with lymph node metastasis than patients without lymph node metastasis(P<0.05).However,rate of infiltration degree<1/2 was significantly lower in patients with lymph node metastasis than patients without lymph node metastasis(P<0.05).There was no significant difference in the rate of either infiltration degree<1/2 or infiltration degree≥1/2 between patients with menopause and without menopause(P>0.05).The sensitivity,specificity and accuracy,positive predictive value and negative predictive value of transvaginal color Doppler ultrasound in diagnosis of degree of myometrial invasion in stageⅠendometrial carcinoma was 84.0%,89.4%,87.5%,80.8%,and 91.3%.The consistency rate and Kappa value of transvaginal ultrasound and pathological diagnosis of stageⅠendometrial carcinoma was 72.2%and 0.580,respectively.Conclusion The efficacy of transvaginal ultrasound in the diagnosis of degree of myometrial invasion in stageⅠendometrial carcinoma is good,and it is worthy of promotion.