宫腔镜直视下子宫内膜活检对子宫内膜癌患者术前病理诊断准确率的影响  

Effect of hysteroscopic endometrial biopsy on the accuracy of preoperative pathological diagnosis in patients with endometrial cancer.

作　　者：关新垒 王世进[1] 王圆圆 张佳 Guan Xinlei;Wang Shijin;Wang Yuanyuan(Department of Gynecology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院妇科,河南新乡453100

出　　处：《云南医药》2021年第1期7-9,共3页Medicine and Pharmacy of Yunnan

摘　　要：目的探究宫腔镜直视下子宫内膜活检对子宫内膜癌(EC)患者术前病理诊断准确率的影响。方法选取我院2015年1月-2016年8月EC患者164例,随机数字表法分组,各82例。对照组行单纯性分段诊刮,观察组行宫腔镜直视下子宫内膜活检联合分段诊刮。对比2组病理诊断准确率、临床分期准确率、腹腔液细胞学阳性率、宫颈受累诊断准确率、3年生存率,并分析腹腔液细胞学阳性相关因素。结果观察组病理诊断准确率、明确临床分期率、临床分期准确率高于对照组(P<0.05);2组腹腔液细胞学阳性率无显著差异(P>0.05);观察组宫颈受累诊断准确率97.56%高于对照组85.37%(P<0.05);腹腔液细胞学阳性率与宫腔病灶范围、附件转移有关(P<0.05),与肌层浸润深度、淋巴结转移、组织学分型无关(P>0.05);2组3年生存率无显著差异(P>0.05)。结论宫腔镜直视下子宫内膜活检可提高EC患者术前病理诊断及临床分期准确率,准确了解宫颈受累情况,且对患者预后及生存率无影响。Objective To investigate the effect of hysteroscopic endometrial biopsy on the accuracy of preoperative pathological diagnosis in patients with endometrial cancer(EC).Methods 164 cases of EC patients in our hospital from January 2015 to August 2016 were selected,and 82 cases were grouped by random number table method.The control group received simple sectional examination and curettage,while the observation group received hysteroscopic endometrial biopsy combined with sectional examination and curettage.The accuracy rate of pathological diagnosis,the accuracy rate of clinical staging,the positive rate of abdominal fluid cytology,the accuracy rate of cervical involvement diagnosis,and the 3-year survival rate of the two groups were compared,and the correlation factors of positive abdominal fluid cytology were analyzed.Results The accuracy rate of pathological diagnosis,clear clinical staging rate and clinical staging accuracy of the observation group were higher than that of the control group(P<0.05).There was no significant difference in the positive rate of peritoneal fluid cytology between the two groups(P>0.05).The accuracy rate of diagnosis of cervical involvement in the observation group was 97.56%higher than that in the control group(P<0.05).The positive rate of peritoneal fluid cytology was related to the range of intrauterine lesions and accessory metastasis(P<0.05),but not to the depth of muscular infiltration,lymph node metastasis and tissue type(P>0.05).There was no significant difference in 3-year survival rate between the two groups(P>0.05).Conclusion Endometrial biopsy under hysteroscopy can improve the accuracy of preoperative pathological diagnosis and clinical staging of EC patients,accurately understand the cervical involvement,and have no impact on the prognosis and survival rate of patients.

关 键 词：分段诊刮 宫腔镜 活检 子宫内膜癌 

分 类 号：R737.33[医药卫生—肿瘤]