子宫内膜细胞学检查在绝经后女性中的应用价值  

Diagnostic Value of Endometrial Cytological Test in Postmenopausal Women

作　　者：文佳[1] 陈锐[1] 赵健[1] 董颖[1] 杨曦[1] 廖秦平[1] 

机构地区：[1]北京大学第一医院,北京100034

出　　处：《实用妇产科杂志》2015年第7期527-529,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:评价绝经后女性子宫内膜细胞学取材满意度和应用子宫内膜细胞学检查(ECT)诊断子宫内膜癌及癌前病变的准确性。方法:1045例绝经后女性采用子宫内膜细胞学取材器(SAP-1)刷取细胞学标本,222例进行宫腔镜下活检或分段诊刮(D&C)术或子宫全切除术获取组织标本。比较两种方法采集标本的满意度情况,及绝经年限和子宫内膜厚度对两种取材法标本满意度的影响,另对ECT的诊断效能进行判断。结果:11045例细胞学标本中仅39例(3.7%)不充分,222例女性子宫内膜组织学标本中82例(36.9%)不充分,两者差异有统计学意义(P<0.05)。2细胞学标本充分组和不充分组病例的绝经年限、子宫内膜厚度的均值比较,差异均无统计学意义(P>0.05)。组织学标本充分组与不充分组病例的绝经年限、子宫内膜厚度的均值比较,差异有统计学意义(P<0.05),组织学不充分组绝经年限≥10年和子宫内膜厚度≤4 mm的病例更多见(P<0.05)。3ECT检查诊断绝经后女性子宫内膜癌及不典型增生的准确度是93.4%,敏感度、特异度、阳性预测值、阴性预测值分别为72.4%、99.1%、95.5%、93.0%。结论:细胞学取材术比组织学取材能提供更充分的标本,ECT可能成为筛查绝经后女性子宫内膜癌及癌前病变可靠的方法。Objective：To evaluate specimen adequacy of endometrial cytological test（ ECT） and its accuracy to diagnose endometrial carcinoma and precursor in postmenopausal women. Methods： Endometrial cytological specimens were collected from 1045 postmenopausal women by SAP-1 device,of which,222 cases of histological specimens were collected by endometrial biopsy, dilatation and curettage（D＆C） or hysterectomy. Specimen adequacy and the influence of menopausal term and endometrial thickness on specimen adequacy were compared, and also the diagnostic capability of ECT was estimated. Results ：（1）In 1045 cytological specimens obtained from SAP-1, only 39 （3. 7% ） cases were inadequate, while 82 of 222 endometrial biopsy specimens （36.9%） cases were inadequate,cytology can provided more sufficient materialthan biopsy （ P 〈 0. 05）. （2）No significant differences was observed between adequate and inadequate cytological specimens group in menopausal term and endometrial thickness（ P 〉 0. 05）. The differences of menopausal term and endometrial thickness between adequate histological group and inadequate group were significant（ P 〈0.05） ,the rate of menopausal term no less than 10 years（ P〈0. 05）and endometrial thickness no more than 4 mm （P 〈 0.05）of inadequate histology group were significantly higher than that in adequate group. （3）The accuracy of ECT in postmenopausal women for endometrial carcinoma and atypical hyperplasia was 93. 4% ,while Se, Sp, PPV, NPV were 72.4% ,99. 1% ,95.5% ,93.0% respectively. Conclusions：ECT can provide more adequate specimens than biopsy and may become a reliable method for screening endometrial carcinoma and its precursor in postmenopausal women.

关 键 词：子宫内膜癌 子宫内膜细胞学检查 诊断准确性 绝经后女性 

分 类 号：R737.33[医药卫生—肿瘤]