宫腔镜下子宫内膜活检及分段诊刮术在子宫内膜癌早期诊断中的应用价值  

Application Value of Hysteroscopic Endometrial Biopsy Combined with Segmental Diagnostic Curettage in Early Diagnosis of Endometrial Cancer

作　　者：方芳 吕丹 FANG Fang;LYU Dan(Department of Gynecology,3201 Hospital,Hanzhong,Shaanxi 723000,China)

机构地区：[1]陕西省汉中市三二〇一医院妇科,陕西汉中723000

出　　处：《解放军医药杂志》2020年第12期23-26,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省自然科学基础研究计划项目任务(2016JM105)。

摘　　要：目的分析宫腔镜下子宫内膜活检及分段诊刮术在子宫内膜癌早期诊断中的应用价值。方法选取2015年1月—2020年4月接受手术治疗的163例子宫内膜癌患者作为研究对象,根据不同的子宫检查方法分为A组54例和B组109例。A组采用宫腔镜下活检及分段诊刮术;B组采用单纯的分段诊刮术。比较2组术前病理诊断的准确性、术前宫颈受累情况诊断可靠性及腹腔冲洗液细胞学阳性率,分析腹腔冲洗液细胞学阳性的相关因素。结果A组术前病理诊断准确率、术后病理类型符合率、宫颈受累诊断准确度均明显高于B组(P<0.05)。2组腹腔冲洗液细胞学阳性率比较差异无统计学意义(P>0.05)。腹腔冲洗液细胞学阳性率与附件转移及肌层浸润深度有关(P<0.05),而与肿瘤组织学类型、脉管瘤栓及淋巴结转移无关(P>0.05)。结论宫腔镜下子宫内膜活检及分段诊刮术是一种安全、有效的检查方法,可有效提高术前病理诊断准确率,准确了解宫颈是否受累,且不会增加癌细胞腹腔播散风险。Objective To analyze the application value of hysteroscopic endometrial biopsy combined with segmental diagnostic curettage in early diagnosis of endometrial cancer.Methods A total of 163 patients with endometrial cancer who underwent surgical treatment from January 2015 to April 2020 were selected as the study subjects,and were divided into group A(n=54)and group B(n=109)according to different uterine examination methods.Group A was treated with hysteroscopic biopsy and segmental diagnostic curettage,and group B was treated with simple segmental diagnostic curettage.The accuracy of preoperative pathological diagnosis,the reliability of preoperative cervical involvement,and the cytological positive rate by peritoneal lavage cytology(PLC)were compared between the two groups,and the related factors of cytological positive rate by PLC were analyzed.Results The accuracy of preoperative pathological diagnosis,the coincidence rate of postoperative pathological types and the diagnostic accuracy of cervical involvement in group A were significantly higher than those in group B(P<0.05).There was no significant difference in the cytological positive rate by PLC between the two groups(P>0.05).The cytological positive rate by PLC was related to adnexa metastasis and depth of myometrial invasion(P<0.05),and was not related to tumor histological type,vascular tumor thrombus and lymph node metastasis(P>0.05).Conclusion Hysteroscopic endometrial biopsy combined with segmental diagnostic curettage is a safe and effective examination method,which can effectively improve the accuracy of preoperative pathological diagnosis,accurately understand whether the cervix is involved,and will not increase the risk of spread to the abdominal cavity of cancer cell.

关 键 词：子宫内膜肿瘤 宫腔镜检查 分段诊刮术 诊断 癌症早期检测 

分 类 号：R737.33[医药卫生—肿瘤]