Loiacono Rosalia Maria Rita, Trojano Giuseppe, Del Gaudio Nicola, Kardhashi Anila, Deliso Maria Assunta, Falco Gaetano, Sforza Rita, Laera Anna Franca, Galise Ida, Trojano Vito
Division of Gynaecologic Oncology, Apulian Cancer Registry, National Cancer Research Centre, Istituto Tumori 'Giovanni Paolo II', Bari, Italy.
Gynecol Obstet Invest. 2015;79(3):210-6. doi: 10.1159/000371758. Epub 2015 Mar 10.
This study compares hysteroscopic and histopathological results in postmenopausal women with abnormal uterine bleeding (AUB) and asymptomatic postmenopausal women with a thickened endometrium.
This is a retrospective study of 570 cases hysteroscopically examined between January 2008 and July 2012. The patients were followed up at the Istituto Tumori 'Giovanni Paolo II', Bari, Italy.
A total of 320 of the 570 cases were selected. The inclusion criteria were transvaginal ultrasound, hysteroscopy and endometrial biopsy. In the AUB group, if the hysteroscopy results were normal, a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100, 95, 71 and 100%, respectively, were achieved, while in the asymptomatic group these values were 100, 97, 90 and 100%, respectively. For both the group with polyps and that with myomas, the sensitivity, specificity, PPV and NPV were 100%. For endometrial hyperplasia, hysteroscopy showed a sensitivity, specificity, PPV and NPV of 81, 96, 87 and 93%, respectively, in the AUB group, while in the asymptomatic group, the sensitivity was 60%, the specificity and PPV were 100%, and the NPV was 98%. The sensitivity of hysteroscopy for endometrial cancer was 63%, the specificity 97%, the PPV 77%, and the NPV 95%.
In postmenopausal women with a thickened endometrium with or without AUB, hysteroscopy allows for an accurate diagnosis in benign endometrial pathology. Hysteroscopy also allows directed biopsies of suspicious lesions, which is useful in malignant endometrial pathology.
本研究比较绝经后异常子宫出血（AUB）妇女及子宫内膜增厚的无症状绝经后妇女的宫腔镜检查结果与组织病理学结果。
这是一项对2008年1月至2012年7月间接受宫腔镜检查的570例病例的回顾性研究。患者在意大利巴里的“乔瓦尼·保罗二世”肿瘤研究所接受随访。
570例病例中共有320例被选中。纳入标准为经阴道超声、宫腔镜检查及子宫内膜活检。在AUB组中，若宫腔镜检查结果正常，其灵敏度、特异度、阳性预测值（PPV）及阴性预测值（NPV）分别为100%、95%、71%及100%，而在无症状组中，这些值分别为100%、97%、90%及100%。对于息肉组和肌瘤组，灵敏度、特异度、PPV及NPV均为100%。对于子宫内膜增生，在AUB组中，宫腔镜检查的灵敏度、特异度、PPV及NPV分别为81%、96%、87%及93%，而在无症状组中，灵敏度为60%，特异度和PPV为100%，NPV为98%。宫腔镜检查对子宫内膜癌的灵敏度为63%，特异度为97%，PPV为77%，NPV为95%。
在有或无AUB的子宫内膜增厚的绝经后妇女中，宫腔镜检查可对良性子宫内膜病变进行准确诊断。宫腔镜检查还可对可疑病变进行靶向活检，这在恶性子宫内膜病变中很有用。
