高频超声联合弹性成像引导下穿刺活检对早期颈管型宫颈癌的术前诊断价值分析  

Value of transvaginal ultrasound-guided needle biopsy combined virtual touch tissue imaging in preoperative diagnosis of early endocervical carcinoma

作　　者：李玲 翟渊鹏 李潜 高玲 LI Ling;ZHAI Yuanpeng;LI Qian;GAO Ling(Department of Ultrasound,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China;Department of Gynecology,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院超声科,郑州450008 [2]郑州大学附属肿瘤医院妇瘤科,郑州450008

出　　处：《中国妇产科临床杂志》2024年第5期400-403,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：河南省医学科技攻关计划项目(LHGJ20210193)。

摘　　要：目的探讨高频超声联合弹性成像引导下穿刺活检在早期宫颈癌术前诊断方面的可能性、安全性、准确性及术后并发症的研究。方法回顾性分析2018年1月至2022年1月于河南省肿瘤医院术后病理诊断为早期宫颈癌的74例患者,比较分析阴道镜下宫颈多点活检术、阴道镜下宫颈多点活检术+宫颈管内膜刮取术及经阴道高频超声联合弹性成像(virtual touch tissue imaging,VTI)引导下宫颈肿物活检术的术前诊断准确率及出血情况。结果以术后病理为诊断“金标准”,阴道镜下宫颈多点活检术、阴道镜下宫颈多点活检+宫颈管内膜刮取术及经阴道高频超声联合弹性成像引导下宫颈肿物穿刺活检术对早期宫颈癌的术前诊断准确率分别为45.00%(9/20例),66.67%(20/30例),83.33%(20/24例)。针对早期宫颈癌,经阴道高频超声联合弹性成像引导下宫颈肿物穿刺术的诊断准确率高于阴道镜下宫颈多点活检+宫颈管内膜刮取术,高于阴道镜下宫颈多点活检术,差异均有统计学意义(P<0.001)。三组患者活检后均出现不同程度的创面出血,经阴道高频超声联合弹性成像引导下穿刺活检组出血量明显较少。结论经阴道高频超声联合弹性成像引导下宫颈肿物穿刺活检技术对早期可疑宫颈癌可以精准定位,是一种比较准确的术前诊断手段,可获得较为满意的组织病理学诊断,是早期可疑宫颈癌患者常规阴道镜下取活检及宫颈管内膜刮取术的有效补充方法。Objective To investigate the possibility,safety and accuracy of transvaginal ultrasound-guided needle biopsy combined virtual touch tissue imaging(VTI)in preoperative diagnosis of early endocervical carcinoma.Methods A retrospective analysis was performed on 74 patients diagnosed as early endocervical carcinoma by postoperative pathology.We analyzed the diagnostic value of three preoperative biopsy methods including cervical biopsy under colposcopy,cervical biopsy under colposcopy plus endocervical curettage and transvaginal ultrasound combined VTI guided needle biopsy.Results The diagnostic accuracy of cervical biopsy under colposcopy,cervical biopsy under colposcopy plus endocervical curettage and transvaginal-ultrasound combined VTI guided needle biopsy was 45.00%(9/20 cases),66.67%(20/30 cases)and 83.33%(20/24 cases),respectively.For early endocervical carcinoma,the diagnostic accuracy of transvaginal-ultrasound combined VTI guided needle biopsy was higher than that of cervical biopsy under colposcopy plus endocervical curettage(P<0.001),and higher than that of cervical biopsy under colposcopy(P<0.001),and the differences were statistically significant.All patients in the three groups had different degrees of wound bleeding after biopsy,and the amount of bleeding in the transvaginal-ultrasound combined-guided VTI needle biopsy group was significantly less.Conclusions Transvaginal ultrasound combined VTI guided biopsy is an accurate preoperative diagnosis method for suspected early endocervical carcinoma.It is an effective supplementary method for routine"three-step"technigue and endocervical curettage in patients with suspected early endocervical carcinoma.

关 键 词：早期宫颈癌 弹性成像 超声引导下穿刺活检 

分 类 号：R737.33[医药卫生—肿瘤]