Matsuura K, Honda Y, Nishimura K, Yamamoto S, Furuki Y, Okamura H
Department of Obstetrics and Gynecology, Kumamoto University Medical School.
Nihon Sanka Fujinka Gakkai Zasshi. 1990 Feb;42(2):174-8.
An outpatient department screening method for endometriosis was prepared by designing a scoring system in a retrospective study. We compared the incidence of 21 characteristic symptoms and the finding of endometriosis in 39 infertile women with endometriosis diagnosed by laparoscopy or laparotomy and 21 women without it. A table for diagnostic scoring composed of 11 items was accomplished. The feasibility of this diagnostic scoring system was then examined in a prospective study of 72 women with endometriosis and 47 without it. The results were as follows. 1. In the retrospective study, all the women with 10 or more points had had endometriosis. Fifteen out of 20 women with -20 points or less had been without endometriosis and the remaining 5 with endometriosis (4 minimal and 1 mild stage according to AFS classification). 2. In the prospective study, a 94.5% (52/55) incidence of endometriosis was found in women with 10 or more points and 66.7% (10/15) of women with -20 points or less were without endometriosis. 3. This diagnostic scoring system, in which women with endometriosis score 10 or more points and women without it -20 points or less, has 91.2% sensitivity, 76.9% specificity, 94.5% positive predictive value and 66.7% of the negative predictive value. It is concluded that this scoring system has clinical diagnostic value in screening for endometriosis in infertile women at the outpatient department.
通过在一项回顾性研究中设计评分系统,制定了一种门诊子宫内膜异位症筛查方法。我们比较了39例经腹腔镜检查或剖腹手术确诊为子宫内膜异位症的不孕妇女和21例未患该病的妇女中21种特征性症状的发生率以及子宫内膜异位症的检查结果。完成了一个由11项组成的诊断评分表。然后,在一项对72例患有子宫内膜异位症的妇女和47例未患该病的妇女的前瞻性研究中检验了该诊断评分系统的可行性。结果如下:1. 在回顾性研究中,所有得分10分及以上的妇女均患有子宫内膜异位症。20例得分-20分及以下的妇女中,15例未患子宫内膜异位症,其余5例患有该病(根据美国生育学会[AFS]分类,4例为微小病变,1例为轻度病变)。2. 在前瞻性研究中,得分10分及以上的妇女中子宫内膜异位症的发生率为94.5%(52/55),得分-20分及以下的妇女中66.7%(10/15)未患子宫内膜异位症。3. 该诊断评分系统中,患有子宫内膜异位症的妇女得分10分及以上,未患该病的妇女得分-20分及以下,其灵敏度为91.2%,特异度为76.9%,阳性预测值为94.5%,阴性预测值为66.7%。结论是,该评分系统在门诊筛查不孕妇女的子宫内膜异位症方面具有临床诊断价值。