子宫内膜采集器在子宫内膜病变诊断中的应用价值

摘要

Objective:To investigate the clinical application of endometrial sampling device (ESD) in the diagnosis of endome trial disorders(ED). Methods: ESD was used to obtain endometrium of 172 patients with suspicious ED in Punan Hospital in Pudong New Area of Shanghai. Cell smears were prepared first and then ESD was rinsed in 10% formaldehyde solution, and granular endometrium material composition was seperated to make paraffin sections. Diagnostic curettages were carried out and the results were considered as standard. The sensitivity and specificity of the two methods using separately or together were analyzed. Results: The diagnostic accordance rate of cell smears, endometrium material composition and their combination were 84. 9%, 94. 8% and 95. 3% , respectively. The diagnostic sensitivity of them were 82. 5%, 93. 7% and 96. 8%, respectively. The diagnostic sensitivity of cell smears was lower than those of endometrium material composition and their combination (P< 0.05). The diagnostic specificity of them were 91. 3%,97. 8%and 91. 3% , respectively, and there were no significant diffe rences among the three groups(P>0. 05). Conclusions: Endometrium specimens obtained by ESD can not only be made as cell smears, but also can be made as paraffin sections, which can improve the sensitivity and specificity in the diagnosis of ED.%目的:探讨子宫内膜采集器(endometrial sampling device,ESD)在子宫内膜病变(endometrial disorders,ED)诊断中的应用价值.方法:对2008年10月-2012年3月就诊于上海市浦东新区浦南医院的172例疑似ED患者应用ESD采集子宫内膜组织,将获取的子宫内膜组织进行细胞涂片；然后将其浸入10％甲醛液中固定,对其中颗粒状的有形成分行石蜡切片及组织学分析.所有患者均同时行诊断性刮宫术,以其病理结果作为诊断“金标准”,分别分析ESD细胞涂片法、有形成分石蜡切片法及两者联合诊断法的诊断符合率,以及三种方法在ED诊断中的敏感度及特异度.结果:ESD细胞涂片法、有形成分石蜡切片法以及两者联合诊断法的诊断符合率分别为84.9％、94.8％、95.3％,细胞涂片法的诊断符合率明显低于有形成分石蜡切片法及联合诊断法(P值均＜0.05),后两者比较差异无统计学意义(P＞0.05)；三者诊断敏感度分别为82.5％、93.7％、96.8％,细胞涂片法的诊断敏感度明显低于有形成分石蜡切片法及联合诊断法(P值均＜0.05),后两者间相比差异无统计学意义(P＞0.05)；三者诊断特异度分别为91.3％、97.8％、91.3％,组间比较差异均无统计学意义(P＞0.05).结论:ESD不仅可用于涂片法细胞学诊断,也可对子宫内膜的有形成分行石蜡切片法组织学诊断,从而提高ESD对于ED的诊断效能.