子宫内膜细胞诊断子宫内膜癌及其癌前病变的临床评价

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1、子宫内膜细胞诊断子宫内膜癌及其癌前病变的临床评价【摘要】目的评价利用子宫内膜细胞采集器(ESDC)行宫腔细胞学检查的方法在子宫内膜癌及其癌前病变诊断中的效果。方法分析419例有异常子宫出血或阴道超声提示宫内异常需行内膜检查的病人，分别使用ESDC采集子宫内膜细胞行细胞学检查与诊断性刮宫行组织病理学检查，并以后者的诊断结果为标准进行对比，观察细胞学检查方法对子宫内膜癌及其癌前病变诊断的评价指标。结果细胞学检查取材满意率82.8%(347/419)，诊断性刮宫取材满意率87.1%(365/419)，二者比较，差异无统计学意义(P>0.05)。ESDC取

2、材时基本不用扩张宫颈，而诊刮术时有90.9%(381/419)的患者需扩张宫颈。EDSC诊断子宫内膜癌和内膜癌早期病变的灵敏度为87.5%(7/8)和87.2%(34/39)，特异度为100%(334/334)和91.9%(271/295)，假阳性率为0和8.1%(24/295)，假阴性率为12.5%(1/8)和12.8%(5/39)，阳性预测值为100%(7/7)和58.6%(34/58);阴性预测值为99.7%(334/335)和98.2%(271/276)。结论子宫内膜细胞采集器应用于子宫内膜癌及其癌前病变的检查准确性较高，具有临床应用价值，

3、可适用于症状人群及高危人群的筛查及门诊随访。【关键词】子宫内膜癌;癌前病变;子宫内膜细胞采集器　ClinicalevaluationofanendometrialsamplingdeviceforcytologyinthedetectionofendometrialcarcinomaandprecarcinomalesionZHAOXin,ZHOUQiang,GUMingjie,etal.MaternityandInfentHealthHospitalofPuTuoDistrict,Shanghai200060,Chian【Abstract】Obj

4、ectiveToevaluatedtheeffectofendometrialsamplingdeviceforcytology(ESDC)comparedtodilatationandcurettageonthedetectionofendometrialcarcinomaandprecarcinomalesion.MehtodsAretrospectivedataof419caseswithsuspectedendometrialpathologicalchangesexaminedbyacombinationofESDCanddilatati

5、onandcurettagewasanalyzed,withhistopathologicalassessmentasthegoldstandardforendometrialcarcinoma.ResultThesamplingsuccessratewas82.8%(347/419)forESDCand87.1%fordilatationandcurettagedifference(χ2=3.33，P>0.05).NoESDCcaseshavereceiveddilatationcervix,381cases(90.9%)withdila

6、tationandcurettagesamplinghavereceivedthedilatedcervix.Whenwecategorizedthecasesstudiedas,ThediagnosticsensitivityofendometrialcytologybyESDCwas87.5%and87.2%forendometrialcarcinomaandprecaricnomalesion,respectively;thespecificitywas100%and91.9%;thepositivepredictivevaluewas100

7、%and58.6%;thenegativepredictivevaluewas99.7%and98.2%,respectively.ConclusionTheESDCwasaccurate,effective,andvaluablefortheearlydetectionofendometrialcarcinomaandprecarcinomalesion.Itisausefulclinicalscreeningmethodforsymptomaticpatientsandasymptomaticpatientswithriskfactors.【K

8、eywords】Endometrialcarcinoma;Precarcinomalesion;Endometrialsa