目的 探讨宫腔镜检查与子宫内膜癌癌细胞播散的相关性.方法 计算机检索Pubmed、EMbase、CNKI及万方数据库中与子宫内膜癌术前应用宫腔镜检查相关的随机对照试验研究,同时手工检索纳入文献的参考文献,检索时间为1996年4月-2012年4月.依据纳入和排除标准筛选文献,在资料提取和质量评价后应用Rev Man 5.1等软件进行Meta分析.结果 共纳入16篇文献2515例,其中7篇中文文献,9篇外文文献.Meta分析结果显示,腹腔积液肿瘤细胞学检查阳性率宫腔镜组高于非宫腔镜组,两组比较差异有统计学意义[OR =1.72,95％ CI(1.28,2.29),P=0.003]；16篇文献中3篇特别比较了Ⅰ、Ⅱ期子宫内膜癌腹腔积液肿瘤细胞学检查阳性率,Meta分析结果显示宫腔镜组与非宫腔镜组比较差异无统计学意义[OR =2.97,95％ CI (0.82,10.70),P=0.10].结论 宫腔镜检查可增加子宫内膜癌患者腹腔积液肿瘤细胞学检查阳性率,但在疾病早期(Ⅰ、Ⅱ期)应用不会引起癌细胞播散.%Objective To evaluate correlation between hysteroscopy and peritoneal dissemination of endometrial cancer cells. Methods The related and randomized controlled trials (RCT) of hysteroscopy were searched from Pubmed, EMbase, CNKI and Wanfang database, and the included literature during April 1996 and April 2012 was searched by hand. The Meta analysis was performed with Rev Man 5.1 software after selections and quality evaluations were studied. Results A total of 16 literature involving 2515 patients met the inclusion criteria, 7 literature was Chinese and 9 literature was from overseas. The positive incidence of seroperitoneum oncocytology examination in hysteroscopes group was significantly higher than that in non- hysteroscopes group by meta analysis [ OR = 1.72, 95% CI (1.28, 2.29 ) , P = 0.003 ] ; in 3 literature the differences of positive incidence of seroperitoneum oncocytology examination in patients with cancer of endometrium (stages Ⅰor Ⅱ) between hysteroscopes group and non-hysteroscopes group was not statistically significant [OR =2.97, 95%CI(0.82, 10.70) , P =0.10]. Conclusion Hysteroscopy for patients with endometrial cancer may increase the positive incidence of seroperitoneum oncocytology examination, but it will not bring about dissemination of malignant cells in stage I and II disease.
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