Background Diagnostic hysteroscopy and directed biopsy has been widely used to evaluate abnormal uterine bleeding. We aimed to explore the value of hysteroscopy and directed biopsy in the diagnosis of endometrial carc...Background Diagnostic hysteroscopy and directed biopsy has been widely used to evaluate abnormal uterine bleeding. We aimed to explore the value of hysteroscopy and directed biopsy in the diagnosis of endometrial carcinoma.Methods Two hundred and eighty-seven patients with endometrial carcinoma who were treated in Beijing University People＇s Hospital, Beijing, China were distributed into 2 groups： Group A （90 patients） was examined using hysteroscopy and directed biopsy, and Group B （197 patients） was examined using fractional dilatation and curettage （D＆C）. The diagnostic veracity of the two methods, the rate of positive peritoneal cytology and the prognosis of the 2 groups were compared.Results In Group A, 97.8% （88/90） of patients were diagnosed pathologically before surgery; the rate was 88.8% （175/197） for Group B. The difference between the 2 groups was statistically significant （P ＜0.05）. The sensitivity,specificity, positive predictive value and negative predictive value for the two methods for detecting cervical involvement were 77.8%, 100%, 100% and 97.6% for Group Aand 65.3%, 92.6%, 74.4% and 90.0% for Group B, respectively. The positive peritoneal cytology rate was 5.6% （5/90） in Group A and 6.09% （12/197） in Group B. The difference was not statistically significant （P ＞0.05）. The 3-year and 5-year overall survival rates were 91.4% （33/36） and 82.4% （14/17） for Group A and 95.6% （87/91） and 86.7% （39/45） for Group B. There were no statistically significant differences between the two groups＇ survival rates （P ＞0.05）.Conclusion Compared with fractional D＆C, hysteroscopy and directed biopsy offered improved pathological diagnostic accuracy before surgery and discovered cervical involvement more precisely in endometrial carcinoma patients, but it did not increase the positive peritoneal cytology rate or affect the prognosis of these patients.展开更多
目的:评价Pipelle de Cornier子宫内膜取样器(取样器)获取子宫内膜组织进行组织学诊断的准确性。方法:收集2011年8月至11月解放军总医院妇产科需行诊断性刮宫的245例患者,行常规诊刮前用取样器先获取子宫内膜组织。由同一病理医师进...目的:评价Pipelle de Cornier子宫内膜取样器(取样器)获取子宫内膜组织进行组织学诊断的准确性。方法:收集2011年8月至11月解放军总医院妇产科需行诊断性刮宫的245例患者,行常规诊刮前用取样器先获取子宫内膜组织。由同一病理医师进行评估并作出组织学诊断。结果:(1)刮匙法的取材失败率(7.75%)与取样器法(8.98%)比较,无显著差异(P>0.05)。取材失败者主要为绝经后病例。刮匙法与取样器法的标本满意度比较,无显著差异(P>0.05)。(2)病理诊断可对比者219例,诊断符合率93.6%(205/219)。两种取材方法在子宫内膜癌、子宫内膜单纯增生、不典型增生、子宫内膜息肉、子宫内膜炎等病变中的诊断准确率均无显著差异。8例子宫内膜癌患者,两种取材方法均无漏诊。(3)取样器取材患者疼痛感显著小于刮匙组(P<0.001)。结论:Pipelle de Cornier子宫内膜取样器能够获取满意的标本用于组织学诊断,可用于大部分需常规诊断性刮宫的病例。展开更多
背景与目的:以往子宫内膜癌宫颈浸润术前诊断依据分段诊断性刮宫得出,而其方法的可靠性受到质疑。因此本文旨在提高术前诊断子宫内膜癌宫颈浸润的准确性,减少手术过治或手术不到位的状况,为制定最佳治疗方案提供依据。方法:术前同时接...背景与目的:以往子宫内膜癌宫颈浸润术前诊断依据分段诊断性刮宫得出,而其方法的可靠性受到质疑。因此本文旨在提高术前诊断子宫内膜癌宫颈浸润的准确性,减少手术过治或手术不到位的状况,为制定最佳治疗方案提供依据。方法:术前同时接受分段诊刮(dilatations and curettages,D&C)和核磁共振成像(MRI),术后组织病理诊断。其中被任意一项检查方式诊断为宫颈受累的子宫内膜癌患者共34例。分段诊刮、MRI的诊断结果分别与术后组织病理诊断进行比较,比较分析两种方法判断子宫内膜癌宫颈浸润的敏感性、特异性及准确率。结果:34例中手术临床病理分期Ⅱ期即宫颈浸润21例,分段诊刮诊断符合率26.5%、MRI为80%,其敏感性、特异性、准确率MRI显著优于分段诊刮。结论:盆腔MRI并增强检查作为术前判断子宫内膜癌肌层浸润和宫颈浸润之首选,可作为制定治疗方案的可靠依据之一。展开更多
目的探讨诊断性宫腔镜在子宫内膜癌诊断中的价值及腹腔手术治疗子宫内膜癌的临床效果。方法回顾性分析36例子宫内膜癌患者的临床资料。结果 17例行分段诊断性刮宫(诊刮),19例行诊断性宫腔镜,两组子宫切除术前与术后病理诊断符合率分别为...目的探讨诊断性宫腔镜在子宫内膜癌诊断中的价值及腹腔手术治疗子宫内膜癌的临床效果。方法回顾性分析36例子宫内膜癌患者的临床资料。结果 17例行分段诊断性刮宫(诊刮),19例行诊断性宫腔镜,两组子宫切除术前与术后病理诊断符合率分别为64.7%(11/17)及94.7%(18/19),差异有显著性(P<0.05);其腹腔积液细胞学阳性率分别为5.9%(1/17)及10.5%(2/19),差异均无显著性(P>0.05);在Ⅰ期子宫内膜癌诊断中,宫腔镜组与诊刮组的准确性分别为92.9%(13/14)和57.1%(8/14),差异无统计学意义(P=0.074)。腹腔镜组(29例)和开腹组(7例)在术中出血量(121.7ml vs 271.4ml,P=0.0060)和术后肛门排气时间(38.6±8.5 h vs 51.6±8.6 h,P=0.0057)比较,差异均有显著性;平均手术时间(245.0±71.3min vs 260.0±73.9 min,P=0.6228)、清除盆腔淋巴结数量(22.3±7.2 vs 21.3±9.0,P=0.8205)、术后住院天数(10.2±2.6 vs 12.1±2.1,P=0.0669)等比较,差异均无显著性。随访期间,开腹组1例复发死亡。结论宫腔镜检查并定位活检诊断子宫内膜癌的准确性高,是否造成子宫内膜癌细胞腹膜腔播散尚存在争议;腹腔镜手术能达到与开腹手术一样的效果。展开更多
文摘Background Diagnostic hysteroscopy and directed biopsy has been widely used to evaluate abnormal uterine bleeding. We aimed to explore the value of hysteroscopy and directed biopsy in the diagnosis of endometrial carcinoma.Methods Two hundred and eighty-seven patients with endometrial carcinoma who were treated in Beijing University People＇s Hospital, Beijing, China were distributed into 2 groups： Group A （90 patients） was examined using hysteroscopy and directed biopsy, and Group B （197 patients） was examined using fractional dilatation and curettage （D＆C）. The diagnostic veracity of the two methods, the rate of positive peritoneal cytology and the prognosis of the 2 groups were compared.Results In Group A, 97.8% （88/90） of patients were diagnosed pathologically before surgery; the rate was 88.8% （175/197） for Group B. The difference between the 2 groups was statistically significant （P ＜0.05）. The sensitivity,specificity, positive predictive value and negative predictive value for the two methods for detecting cervical involvement were 77.8%, 100%, 100% and 97.6% for Group Aand 65.3%, 92.6%, 74.4% and 90.0% for Group B, respectively. The positive peritoneal cytology rate was 5.6% （5/90） in Group A and 6.09% （12/197） in Group B. The difference was not statistically significant （P ＞0.05）. The 3-year and 5-year overall survival rates were 91.4% （33/36） and 82.4% （14/17） for Group A and 95.6% （87/91） and 86.7% （39/45） for Group B. There were no statistically significant differences between the two groups＇ survival rates （P ＞0.05）.Conclusion Compared with fractional D＆C, hysteroscopy and directed biopsy offered improved pathological diagnostic accuracy before surgery and discovered cervical involvement more precisely in endometrial carcinoma patients, but it did not increase the positive peritoneal cytology rate or affect the prognosis of these patients.
文摘目的:评价Pipelle de Cornier子宫内膜取样器(取样器)获取子宫内膜组织进行组织学诊断的准确性。方法:收集2011年8月至11月解放军总医院妇产科需行诊断性刮宫的245例患者,行常规诊刮前用取样器先获取子宫内膜组织。由同一病理医师进行评估并作出组织学诊断。结果:(1)刮匙法的取材失败率(7.75%)与取样器法(8.98%)比较,无显著差异(P>0.05)。取材失败者主要为绝经后病例。刮匙法与取样器法的标本满意度比较,无显著差异(P>0.05)。(2)病理诊断可对比者219例,诊断符合率93.6%(205/219)。两种取材方法在子宫内膜癌、子宫内膜单纯增生、不典型增生、子宫内膜息肉、子宫内膜炎等病变中的诊断准确率均无显著差异。8例子宫内膜癌患者,两种取材方法均无漏诊。(3)取样器取材患者疼痛感显著小于刮匙组(P<0.001)。结论:Pipelle de Cornier子宫内膜取样器能够获取满意的标本用于组织学诊断,可用于大部分需常规诊断性刮宫的病例。
文摘背景与目的:以往子宫内膜癌宫颈浸润术前诊断依据分段诊断性刮宫得出,而其方法的可靠性受到质疑。因此本文旨在提高术前诊断子宫内膜癌宫颈浸润的准确性,减少手术过治或手术不到位的状况,为制定最佳治疗方案提供依据。方法:术前同时接受分段诊刮(dilatations and curettages,D&C)和核磁共振成像(MRI),术后组织病理诊断。其中被任意一项检查方式诊断为宫颈受累的子宫内膜癌患者共34例。分段诊刮、MRI的诊断结果分别与术后组织病理诊断进行比较,比较分析两种方法判断子宫内膜癌宫颈浸润的敏感性、特异性及准确率。结果:34例中手术临床病理分期Ⅱ期即宫颈浸润21例,分段诊刮诊断符合率26.5%、MRI为80%,其敏感性、特异性、准确率MRI显著优于分段诊刮。结论:盆腔MRI并增强检查作为术前判断子宫内膜癌肌层浸润和宫颈浸润之首选,可作为制定治疗方案的可靠依据之一。
文摘目的探讨诊断性宫腔镜在子宫内膜癌诊断中的价值及腹腔手术治疗子宫内膜癌的临床效果。方法回顾性分析36例子宫内膜癌患者的临床资料。结果 17例行分段诊断性刮宫(诊刮),19例行诊断性宫腔镜,两组子宫切除术前与术后病理诊断符合率分别为64.7%(11/17)及94.7%(18/19),差异有显著性(P<0.05);其腹腔积液细胞学阳性率分别为5.9%(1/17)及10.5%(2/19),差异均无显著性(P>0.05);在Ⅰ期子宫内膜癌诊断中,宫腔镜组与诊刮组的准确性分别为92.9%(13/14)和57.1%(8/14),差异无统计学意义(P=0.074)。腹腔镜组(29例)和开腹组(7例)在术中出血量(121.7ml vs 271.4ml,P=0.0060)和术后肛门排气时间(38.6±8.5 h vs 51.6±8.6 h,P=0.0057)比较,差异均有显著性;平均手术时间(245.0±71.3min vs 260.0±73.9 min,P=0.6228)、清除盆腔淋巴结数量(22.3±7.2 vs 21.3±9.0,P=0.8205)、术后住院天数(10.2±2.6 vs 12.1±2.1,P=0.0669)等比较,差异均无显著性。随访期间,开腹组1例复发死亡。结论宫腔镜检查并定位活检诊断子宫内膜癌的准确性高,是否造成子宫内膜癌细胞腹膜腔播散尚存在争议;腹腔镜手术能达到与开腹手术一样的效果。
