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1、宫腔镜检查对子宫内膜癌的诊断价值北京医科人学学报2000年第3期第32卷论著作者：温宏武王洁刘运明单位：温宏武刘运明(北京大学第一医院妇产科，北京100034)；王洁(中国石油天然气总公司中心医院)关键词：宫腔镜检查；子宫内膜肿瘤；诊断；刮宫术［摘要］目的：探讨宫腔镜检查在子宫内膜癌诊断中的价值。方法：经手术治疗的子宫内膜癌共102例分为两组:(1)宫腔镜检査组(39例),在宫腔镜下行分段诊刮术;(2)单纯分段诊刮组(63例)。比饺两组术前后宫颈受累情况的诊断符合率及开腹手术时腹水细胞学检查的结果。结果：两组患者的年龄、临床分期
2、、病理分级及组织学类型差异无显著性，宫腔镜检查组诊断宫颈受累的准确率为97.4%(38/39),明显高于单纯分段诊刮组(76.2%,48/63),其假阳性率(0/35)明显低于单纯分段诊刮组(21.6%J1/55)(P值均V0.01),两组患者均无腹水，有84.3%(86/102)在开腹手术时行腹腔洗液细胞学检查。宫腔镜检查组腹腔洗液细胞学阳性率为8.8%(3/34),单纯分段诊刮组为13.5%(7/52),两组差异无显著性(P>0.05)o结论：宫腔镜检杳可提高子宫内膜癌诊断的准确性，能较确切地了解宫颈是否受累，同时可能并不增
3、加肿瘤细胞扩散的机会，对可疑宫内病变者应在宫腔镜检查下分段诊刮。［中图分类号］R737.33［文献标识码］A［文章编号］1000-1530(2000)03-0272-03ThevalueofhysteroscopyinthediagnosisofendometrialcancerWENHong-Wu,LIUYun-Ming(DepartmentofObstetricsandGynecology,theFirstHospital,PekingUniversity,Beijing100034,China；)WANGJie(Cente
4、rHospitalofChinaNationalPetroleumCorporation)ABSTRACTObjective:Toevaluatethevalueofhysteroscopyinthediagnosisofendometrialcancer.Methods:OnehundredandtwopatientswithendometrialcancerwerediagnosedandtheoperationswereperformedinourdepartmentfromJan.1990toJune1997・Theyw
5、eredividedintotwogroups・Therewere39patientsinthefirstgroupwhowerediagnosedbyhysteroscopyandfractionalcurettage,andtheother63patientswereinthesecondgroupwhowerediagnosedonlybyfractionalcurettage・Theaccuracyratesfordiagnosisofcervicalcanalinvolvementandperitonealcytolo
6、gyatthetimeoflaparotomywerecomparedbetweenthetwogroups・Results:Therewasnostatisticdifferenceinpatients1age,stage,gradeandhistologicaltypeofthediseasebetweenthetwogroups・Theaccuracyratefordiagnosisofcervicalcanalinvolvementwashigherinthefirstgroup(97.4%,38/39)thaninth
7、esecondgroup(76.2%,48/63),PV0.01,andthefalsepositiveratefordiagnosisofcervicalcanalinvolvementwaslowerinthegroupwithhysteroscopy(0,0/35)thaninthegroupwithouthysteroscopy(21.6%,11/55),P<0.01•Noasciteswasfoundinthepatientsofthetwogroups・Peritonealwashingcytologywasexam
8、inedineighty-sixpatients(84.3%,86/102)atthetimeoflaparotomy.Thepositiveperitonealcytologywasfoundin3patients(8.8%,3/34)inthefirstgr
