宫腔刷取子宫内膜的细胞学及有形成分组织学联合诊断对子宫内膜癌筛查价值的研究  

Caused by intrauterine brush in endometrial cytology and tangible component joint histologic diagnosis of endometrial carcinoma screening value of research

作　　者：李岚[1] 张保华[1] 冯晓丹[1] 申丽[2] 蔡丽虹[1] 顾丹萍[1] 季静[1] 郭洁[1] 曹斐[1] 程薇薇[1] 聂启琴 董兴海 LI Lan ZHANG Bao - hua FENG Xiao - dan SHEN Li CAI Li - hong GU Dan - ping JI Jing GUO Jie CAO Fei CHENG Wei - wei NIE Qi - qin DONG Xinghai(Department Obstetrics and Gynecology,Punan Hospital in Pudong New Area of Shanghai, Shanghai 200000, Chin)

机构地区：[1]上海市浦东新区浦南医院妇产科,上海200000 [2]上海市浦东新区浦南医院病理科,上海200000 [3]上海长宁区妇幼保健院,上海200000

出　　处：《医药论坛杂志》2017年第1期12-15,共4页Journal of Medical Forum

基　　金：上海市浦东新区重点专科项目(PWZz2013-12)

摘　　要：目的探讨宫腔刷取子宫内膜的细胞学及有形成分组织学联合诊断对子宫内膜癌的筛查价值。方法对2014年1月至2014年12月就诊于上海市浦东新区浦南医院的150例具有诊断性刮宫或宫腔镜活检的患者,应用宫腔刷刷取子宫内膜进行液基细胞学诊断,并对刷取出的子宫内膜有形成分进行组织学诊断,同时行诊断性刮宫或宫腔镜活检进行组织学诊断。以诊断性刮宫或宫腔镜活检的组织学诊断结果作为诊断"金标准",分别分析子宫内膜细胞学诊断、有形成分组织学诊断及二者联合诊断的诊断符合率、敏感度及特异度。结果 150例病例中,子宫内膜癌前病变13例,子宫内膜癌12例。宫腔刷取子宫内膜的细胞学诊断、有形成分组织学诊断及联合诊断的诊断符合率分别为96.0%、98.0%和99.3%;敏感度分别为95.2%、100%和96.2%;特异度分别为96.1%、97.7%和100%。宫腔刷不仅可对刷取物进行细胞学诊断同时对刷取的子宫内膜"有形成分"可进行组织学诊断。结论宫腔刷取子宫内膜的细胞学及有形成分组织学联合诊断对对子宫内膜癌及癌前患者具有较高的诊断符合率,敏感度、特异度,有利于子宫内膜癌的筛查;而其中的有形成分组织学诊断与诊刮或宫腔镜活检的组织学诊断具有一致的诊断效果。Objective To investigate the value of cytology and the combination of physical and histological diagnosis of endometrial carcinoma in uterine cavity. Methods Chose 150 cases in Pu Nan hospital in 2014,who should be had diagnostic curettage or hysteroscopy with biopsy. Use uterine brush for liquid based cytology and histological diagnosis of the visible components. At the same time for diagnostic curettage or hysteroscopy and biopsy for histological diagnosis as what is called ＂ gold standard＂. Analyze the diagnosis coincidence rate,sensitivity and specificity in endometrial cytology diagnosis and histological diagnosis of visible components and combination of these two by ＂ gold standard＂. Results There are 13 cases of endometrial precancerous lesions,12 cases of endometrial carcinoma in 150 cases. The diagnosis coincidence rate among the cytological diagnosis,histological diagnosis of the visible components and combined diagnosis（%） were 96. 0,98. 0 and 99. 3; the sensitivity（%） were 95. 2,100 and 96. 2; the specificity（%） were 96. 1,97. 7and 100. The uterine cavity brush can not only carry out the cytology diagnosis of the brush,but also can be used for the histological diagnosis of the visible component of the endometrium. Conclusion Cytological and histological diagnosis of uterine endometrium by uterine cavity brushing has high diagnostic coincidence rate,sensitivity,specificity. It is benefit for endometrial cancer screening. And the histological diagnosis of visible components has the same effect as the diagnostic curettage or hysteroscopy with biopsy.

关 键 词：子宫内膜癌 宫腔刷 细胞学诊断 组织学诊断 筛查 

分 类 号：R737.33[医药卫生—肿瘤]