Hershlag A, Seifer D B, Carcangiu M L, Patton D L, Diamond M P, DeCherney A H
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
Obstet Gynecol. 1991 Mar;77(3):399-405.
In order to examine the ability of salpingoscopy to diagnose intratubal pathology, 32 fallopian tubes were evaluated salpingoscopically and histologically. Both flexible and rigid salpingoscopes were used, and observations were documented by intratubal photography. Salpingoscopic criteria were established and each criterion assigned a numerical value. Each tube was evaluated for patency, mucosal fold architecture, erythema, adhesions, and dilatation. Based on these criteria, tubes were graded as normal or as abnormal with mild, moderate, or severe changes. Histologically, each tube was evaluated for patency, epithelial changes, vascularity, dilatation, adhesions, and active inflammation. Six tubes with significant histologic findings and two histologically normal fallopian tubes were also examined by transmission electron microscopy. In five discordant cases, histology revealed epithelial and stromal changes not detected by salpingoscopy. Fallopian tubes with severe disease were diagnosed by both methods. Transmission electron microscopy of histologically abnormal tubes showed flattening of the epithelium with markedly reduced ciliary distribution, degenerating secretory epithelial cells with large intracellular vacuoles, and swollen nuclei containing sparse chromatin. Our results indicate that salpingoscopic observations are consistent with histologic findings when endotubal disease is severe. However, moderate pathologic changes as documented by light microscopy and transmission electron microscopy were frequently not diagnosed salpingoscopically, even with magnification.
为了检查输卵管镜诊断输卵管内病变的能力，对32条输卵管进行了输卵管镜检查和组织学评估。使用了软性和硬性输卵管镜，并通过输卵管内摄影记录观察结果。制定了输卵管镜检查标准，并为每个标准赋予一个数值。对每条输卵管的通畅性、黏膜皱襞结构、红斑、粘连和扩张情况进行评估。根据这些标准，将输卵管分为正常或异常，异常又分为轻度、中度或重度改变。在组织学上，对每条输卵管的通畅性、上皮变化、血管分布、扩张、粘连和活动性炎症进行评估。对6条有显著组织学发现的输卵管和2条组织学正常的输卵管也进行了透射电子显微镜检查。在5例不一致的病例中，组织学显示输卵管镜检查未发现的上皮和间质变化。两种方法均诊断出患有严重疾病的输卵管。组织学异常的输卵管的透射电子显微镜检查显示上皮扁平，纤毛分布明显减少，分泌上皮细胞退化，细胞内有大空泡，细胞核肿胀，染色质稀疏。我们的结果表明，当输卵管内疾病严重时，输卵管镜检查结果与组织学发现一致。然而，即使使用放大倍数，光学显微镜和透射电子显微镜记录的中度病理变化在输卵管镜检查中也常常无法诊断出来。
