宫腔镜联合子宫内膜CD138检查对异常子宫出血合并慢性子宫内膜炎的诊断分析  

Diagnosis and Analysis of Abnormal Uterine Bleeding Complicated With Chronic Endometritis by Hysteroscopy Combined With Endometrial CD138 Examination

作　　者：朱虹 容文琳 蒋志坚 ZHU Hong;RONG Wenlin;JIANG Zhijian(Department of Gynecology,the People's Hospital of Jiangmen,Jiangmen Guangdong 529000,China;Department of Pathology,the People's Hospital of Jiangmen,Jiangmen Guangdong 529000,China)

机构地区：[1]江门市人民医院妇科,广东江门529000 [2]江门市人民医院病理科,广东江门529000

出　　处：《中国卫生标准管理》2024年第16期35-38,共4页China Health Standard Management

基　　金：江门市科技计划项目(2021YL02029)。

摘　　要：目的研究异常子宫出血(abnormal uterine bleeding,AUB)患者宫腔镜检查情况及子宫内膜膜硫酸乙酰肝素蛋白多糖配体蛋白聚糖-1(syndecan-1 antibody blocking peptide,CD138)表达情况,探讨宫腔镜联合子宫内膜CD138免疫组织化学检查在AUB合并慢性子宫内膜炎(chronic endometritis,CE)中的诊断价值,分析AUB各病因分类中CE的发生率。方法选取2021年1月—2022年12月在江门市人民医院因AUB行宫腔镜检查的322例患者,取子宫内膜组织进行CD138免疫组织化学检查。评估宫腔镜检查联合子宫内膜CD138免疫组织化学检查对AUB合并CE的诊断分析。比较AUB患者按PALM-COEIN病因分类各分类项中CE的发生率。结果322例患者中,宫腔镜联合CD138免疫组织化学检查中CE检出率高于宫腔镜检查,差异有统计学意义(P<0.05)。其中,血人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)阴性的妊娠组织物残留CD138阳性率最高(100%),异常子宫出血-子宫内膜局部异常(abnormal uterine bleeding-endometrial,AUB-E)为96.07%。结论宫腔镜联合子宫内膜CD138检查可提高AUB合并CE的诊断率。hCG阴性的妊娠组织物残留、子宫内膜局部异常的AUB患者中子宫内膜组织CD138阳性表达率增高。Objective To study hysteroscopy and expression of syndecan-1 antibody blocking peptide(CD138)in endometrial membrane of patients with abnormal uterine bleeding(AUB).To explore the diagnostic value of hysteroscopy combined with endometrial CD138 immunohistochemistry examination in AUB complicated with chronic endometritis(CE),and analyze the incidence of CE in pathogenesis classification of AUB.Methods A total of 322 patients who underwent hysteroscopy for AUB in the People's Hospital of Jiangmen from January 2021 to December 2022 were selected,and endometrial tissues were taken for CD138 immunohistochemical examination.The diagnosis of AUB with CE by hysteroscopy combined with endometrial CD138 immunohistochemistry were evaluated.The incidence of CE in each category of the PALM-COEIN in AUB patients was compared.Results In 322 patients,the CE detection rate of hysteroscopy combined with CD138 immunohistochemistry was higher than that of hysteroscopy,the difference was statistically significant(P<0.05).Among 322 patients,the positive rate of residual CD138 in pregnancy tissues with human chorionic gonadotropin(hCG)negative blood was the highest(100%),abnormal uterine bleeding-endometrial(AUB-E)was 96.07%.Conclusion Hysteroscopy combined with endometrial CD138 examination can improve the diagnosis rate of AUB combined with CE.CD138 positive expression rate of endometrial tissue increased in patients with AUB with hCG negative pregnancy tissue residue,endometrial polyps,local abnormalities of endometrial.

关 键 词：宫腔镜 CD138 慢性子宫内膜炎 异常子宫出血 诊断 免疫组织化学 

分 类 号：R711[医药卫生—妇产科学]