联合宫腔刷及宫腔吸管采集子宫内膜在子宫内膜癌筛查中的应用

摘要

Objective To discuss the value of histological diagnosis by using both endometrical sampling brush and sucker to take endometrium in endometrial cancer screening .Methods 150 patients with hysteroscopy biopsy indication were se-lected.Use endometrial sampling brush to take endometrium ,meanwhile suck out another endometrium with endometrial sampling sucker which fall in uterine .After that,diagnose the 2 visible parts of endometrium that acquired by last steps ,at the same time line hysteroscopic biopsy for histologic diagnosis .Finally, by considering the hysteroscopic biopsy for histologic diagnosis as'Golden Standard ' ,analyze the detection ratio of the 2 visible parts of endometrium ,and coincident rate ,sensitivity and specifici-ty of endometrial cancer and precancerous lesion .Results There were 92 patients that were acquired visible part of endometrium by combined usage of endometrical sampling brush and sucker in 150 patients,so the detection ratio was 61.33%,including 11 cases of precancerous lesion and 15 cases of endometrial cancer ,so the detection ratio was 100.00%.In the 15 cases of endomet-rical cancer ,there were 14 cases that was diagnosed by combined usage of endometrial sampling brush and sucker ,so the coinci-dent ratio was 99.33%;sensitivity was 93.33%;specificity was 100.00%.Compared with the 'Golden Standard',all of the fac-tors had no remarkable difference (P were great than 0.05).Conclusion Combined usage of endometrial sampling brush and sucker can improve the detection ratio , which contributes to endometrial cancer screening .The visible part of endometrium ac-quired by endometrical sampling brush is helpful for histological diagnostic .%目的 探讨联合应用宫腔刷及宫腔吸管采集子宫内膜的组织学诊断在子宫内膜癌筛查中的应用价值.方法 选取具有宫腔镜活检指征的患者,先采用宫腔刷刷取子宫内膜,再用宫腔吸管将脱落于宫腔的子宫内膜吸出,对两者获取的子宫内膜"有形成份"经石蜡包埋后进行组织学诊断,同时行宫腔镜活检进行组织学诊断.以宫腔镜活检的组织学诊断作为诊断"金标准",分析联合采样中子宫内膜"有形成份"的检出率以及对子宫内膜癌及癌前病变的诊断符合率、灵敏度及特异度.结果 150例患者中,联合采样获取子宫内膜"有形成份"92例,检出率为61.33%.经宫腔镜活检确诊癌前病变11例及子宫内膜癌15例.15例子宫内膜癌中,联合采样"有形成份"组织学诊断14例,诊断符合率为93.33%、灵敏度为100.00%、特异度为99.26%.结论 联合应用宫腔刷及宫腔吸管可提高样本检出率,有利于子宫内膜癌的筛查;宫腔刷取子宫内膜"有形成份"有利于子宫内膜癌的组织学诊断.