中国实用妇科与产科杂志2011，Vol.27Issue(6)：439-442,4.
宫腔镜直视下活检及分段诊刮术与单纯分段诊刮术在子宫内膜癌诊断中的应用价值
Value of hysteroscopy with directed biopsy or dilatation and curettage in the diagnosis of endometrial carcinoma.
祝洪澜 1梁旭东 1王建六 1崔恒 1魏丽惠1
作者信息
- 1. 北京大学人民医院妇产科,北京,100044
- 折叠
摘要
Abstract
Objective To explore the value of hysteroscopy with directed biopsy or dilatation and curettage in the diagnosis of endometrial carcinoma. Methods 287 patients with endometrial carcinoma who were treated in our hospital were distributed into 2 groups: Group A (90 patients) was examined using hysteroscopy with directed biopsy or dilatation and curettage, and Group B ( 197 patients) was examined using fractional dilation and curettage (D&C). The diagnostic yeracity of the two methods, the rate of positive peritoneal cytology and the prognosis of the 2 groups were compared. Results In Group A, 97.8 ％ (88/90) of patients were diagnosed pathologically before surgery; the rate was 88.8％ (175/197) for Group B. The difference between the 2 groups was statistically significant (P＜ 0.05). The sensitivity,accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the two methods for detecting cervical involvement were 77. 8％, 97. 8％, 100％ and 97.6％ for Group A and 65. 3％, 85.8％, 74. 4％ and 89. 0％ for Group B, respectively. The positive peritoneal cytology rate was 5.56 ％ (5/90) in Group A and 6. 09％ (12/197) in Group B. The difference was not statistically significant (P ＞ 0. 05 ). The 3-year and 5-year overall survival rates were 91.7％ (33/36) and 82.4％ (14/17) for Group A and 95.6％ (87/91) and 86.7％ (39/45) for Group B. There were no statistically significant differences between the 2 groups'survival rates ( P ＞ 0. 05). Conclusion Compared with fractional D&C, hysteroscopy with directed biopsy or D&C offered improved pathological diagnostic accuracy before surgery and discovered cervical involvement more precisely in endometrial carcinoma patients, but it did not increase the positive peritoneal cytology rate or affect the prognosis of these patients.关键词
宫腔镜/分段诊刮/子宫内膜癌Key words
hysteroscopy/ dilatation and curettage/ endometrial carcinoma分类
医药卫生引用本文复制引用
祝洪澜,梁旭东,王建六,崔恒,魏丽惠..宫腔镜直视下活检及分段诊刮术与单纯分段诊刮术在子宫内膜癌诊断中的应用价值[J].中国实用妇科与产科杂志,2011,27(6):439-442,4.
