宫腔刷取子宫内膜有形成分组织学诊断在子宫内膜病变诊断中的应用  

Clinical application of histological diagnostic of endometrial materiality composition obtained by endometrial sampling device in diagnose of endometrial disorders

作　　者：李岚[1] 张保华[1] 冯晓丹[1] 申丽[2] 曹斐[1] 蔡丽虹[1] 顾丹萍[1] 季静[1] 郭洁[1] 程薇薇[1] 聂启琴 

机构地区：[1]上海市浦东新区浦南医院妇产科,上海200125 [2]上海市浦东新区浦南医院病理科,上海200125

出　　处：《医药论坛杂志》2017年第6期25-27,共3页Journal of Medical Forum

基　　金：上海市浦东新区卫生系统重点专科项目(PWZz2013-12)

摘　　要：目的探讨宫腔刷取子宫内膜有形成分组织学诊断在子宫内膜病变诊断中的应用价值。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指征的患者,应用宫腔刷刷取子宫内膜,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",分析子宫内膜有形成分组织学诊断的诊断符合率以及子宫内膜有形成分的检出率。结果 150名患者中,正常增生期子宫内膜患者22例,分泌期子宫内膜患者9例,子宫息肉35例,萎缩性内膜伴炎症2例,单纯性增生过长47例,复杂性增生过长10例、癌前期非典型增生13例和子宫内膜癌12例。除萎缩性内膜伴炎症(50%)和内膜息肉(14.29%)有形成分检出率较低外,其他病变检出率为80%(复杂性增生过长)或以上。子宫内膜有形成分诊断符合率除增生期子宫内膜(95%)和非典型增生(93.32%)外,均达到100%。卡方检验结果提示,内膜息肉有形成分检出率(14.29%)均显著低于其他病理类型(P<0.05)。其他各种病理类型检出率比较,差异均无统计学意义;各诊断符合率比较,差异性均无统计学意义。结论宫腔刷取子宫内膜有形成分除子宫内膜息肉外均有较高检出率;子宫内膜有形成分组织学诊断具有较高的诊断符合率;子宫内膜有形成分的组织学读片效果与诊刮或宫腔镜活检的组织学读片效果一致。Objective To investigate the value of histological diagnostic of endometrial materiality composition obtained by the endometrial sampling device in diagnose of endometrial disorders. Methods Choose 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 endometrial materiality composition,thereafter carried out diagnostic curettage or hysteroscopy to the same 150 cases,which diagnostic results to be compared as ＂ gold standard＂ and then comparedthe diagnose accordance ratesand relevance ratio of endometrial materiality composition. Results Of the 150 cases,there are 22 cases of proliferative stage endometrial,9 cases of secretory phase endometrial,35 cases of uterine polyp,2 cases of atrophicendometrial inflammation,47 cases of simple hyperplasiaendometrial,10 case of complexity hyperplasia endometrial,13 cases of atypical hyperplasia endometrial and 12 cases of endometrial cancer. The relevance ratio of endometrial materiality compositions of uterine polyp（ 14. 29%） and atrophicendometrial inflammation（ 50%） were lower than that of the others,such as complexity hyperplasia endometrial（ 80%）. The relevance ratio of endometrial materiality compositions of uterine polyp was the lowest of all. The diagnose accordance rates of endometrial materiality compositions of the150 cases are almost 100%, except for proliferative stage endometrial（ 95%） and atypical hyperplasia endometrial（ 93. 32%）. Conclusion The relevance ratios of endometrial materiality compositions were higher except for that of uterine polyp,the diagnose accordance rate of endometrial materiality composition were higher and coincident with ＂ gold standard＂.

关 键 词：子宫内膜病变 宫腔刷 有形成分 组织学诊断 

分 类 号：R711[医药卫生—妇产科学]