宫腔镜检查在绝经后阴道流血妇女中子宫内膜癌的诊断价值  

Diagnostic Value of Hysteroscopy in Endometrial Carcinoma of Postmenopausal Women with Vaginal Bleeding

作　　者：刘彩虹[1] 梁文通[1] 张志军[1] 谭寒星[1] 龚芫 訾聃 Liu Cai-hong;Liang Wen-tong;Zhang Zhi-jun;Tan Han-xing;Gong Yuan;Zi Dan(Department of Gynecology,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou Province,China)

机构地区：[1]贵州省人民医院妇科,贵州贵阳550002

出　　处：《中国社区医师》2022年第13期84-86,共3页Chinese Community Doctors

基　　金：贵州省科技计划项目(课题)任务书(编号:黔科合LH〔2016〕7415)。

摘　　要：目的:探讨宫腔镜检查在绝经后阴道流血妇女中子宫内膜癌的诊断价值。方法:选取贵州省人民医院2018年3月-2019年3月收治的110例绝经后阴道流血妇女的病历资料,入院后均采取妇科超声、宫腔镜及病理检查。以病理诊断结果为准,对比妇科超声、宫腔镜检查对绝经后阴道流血妇女子宫内膜良、恶性病变的诊断价值。结果:以术后病理检查结果为准,子宫内膜良性病变46.36%(51/110),子宫内膜癌32.73%(36/110),无子宫内膜典型增生,正常子宫内膜20.91%(23/100)。宫腔镜检查特异性、准确率、阳性预测值均高于超声检查,差异有统计学意义(P<0.05);两种检查方法灵敏度、阴性预测值比较,差异无统计学意义(P>0.05)。宫腔镜检查诊断子宫内膜癌特异性、准确率、阳性预测值均高于超声检查,差异有统计学意义(P<0.05);两种检查方法灵敏度、阴性预测值比较,差异无统计学意义(P>0.05)。结论:宫腔镜检查用于绝经后阴道流血妇女中子宫内膜良性病变、子宫内膜癌诊断的特异性、准确率及阳性预测值均较高,具有较高的诊断价值,且检查创伤小,尤其适用于老年妇女。Objective:To explore the value of hysteroscopy in the diagnosis of endometrial cancer in postmenopausal women with vaginal bleeding.Methods:From March 2017 to March 2019,the medical record information of 110 postmenopausal women with vaginal bleeding admitted to Guizhou Provincial People's Hospital were selected.All patients underwent gynecological ultrasound,hysteroscopy and pathological examination after admission.The diagnostic value of gynecological ultrasound and hysteroscopy for benign and malignant endometrial lesions in postmenopausal women with vaginal bleeding was compared based on pathological diagnosis results.Results:According to the results of pathological examination after operation,46.36%(51/110)of cases had benign endometrial lesions,32.73%(36/110)of cases had endometrial cancer,and 20.91%(23/100)of cases had no typical endometrial hyperplasia and normal endometrium.The specificity,accuracy and positive predictive value of hysteroscopy were higher than those of ultrasound,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the sensitivity and negative predictive value between two examination methods(P>0.05).In the diagnosis of endometrial cancer,the specificity,accuracy and positive predictive value of hysteroscopy were higher than those of ultrasound,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the sensitivity and negative predictive value between two examination methods(P>0.05).Conclusion:Hysteroscopy has high specificity,accuracy and positive predictive value in the diagnosis of benign endometrial lesions and endometrial cancer in postmenopausal women with vaginal bleeding.It has high diagnostic value and little trauma by examination,especially suitable for elderly women.

关 键 词：宫腔镜 阴道流血 子宫内膜癌 

分 类 号：R737.33[医药卫生—肿瘤]