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[宫腔镜检查及刮宫术在子宫内膜癌诊断中的价值]

[Value of hysteroscopy and dilatation and curettage in diagnosis of endometrial cancer].

作者信息

Li Xiaomao, Yang Xiaohui, Yang Yuebo, Ye Huixia, Ye Minjuan

机构信息

Department of Gynecology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China. Email:

Department of Gynecology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2015 Feb;50(2):120-4.

Abstract

OBJECTIVE

To evaluated the value of hysteroscopy and dilatation and curettage (DC) in diagnosis of endometrial cancer.

METHODS

This retrospective analysis included clinical pathologic data of 3 676 patients with endometrial cancer from Jan. 1, 2000 to Dec. 31, 2010 in hospitals of endometrial cancer prevention projects in Guangdong Province.

RESULTS

A total of 3 676 patients with endometrial cancer were divided into DC group (3 211 patients) and hysteroscopy group (465 patients). Compared to the results of pathological diagnosis, the accuracy rate between DC group and in hysteroscopy group were no statistically difference was 91.00% (2 922/3 211) vs 90.75% (422/465; χ² = 0.030, P = 0.862). The accuracy rate, sensitivity, specificity, positive predictive value and negative predictive value of cervical involvement between DC group and hysteroscopy group were 81.28% vs 86.45% (P < 0.01), 24.78% vs 23.68% (P > 0.05), 93.76% vs 98.71% (P < 0.01), 46.75% vs 78.26% (P < 0.01) and 84.95% vs 86.88% (P > 0.05), respectively. Rate of positive peritoneal cytology in DC group was 4.76% (153/3 211), and the rate was 3.23% (15/465) in hysteroscopy group, which were no statistically difference (χ² = 2.206, P = 0.137). There were no statistically difference in 5-year overall survival (91.02% vs 92.03%; χ² = 0.033, P = 0.856) and 5-year progression-free survival (89.81% vs 91.83%; χ² = 1.508, P = 0.219) between DC group and hysteroscopy group.

CONCLUSIONS

Hysteroscopy and dilatation and curettage is an effective method in diagnosis of endometrial cancer, especially hysteroscopy is better in diagnosis of cervical involvement. Hysteroscopy don't improve risks of positive peritoneal cytology and don't affect the prognosis of patients with endometrial cancer.

摘要

目的

评估宫腔镜检查及刮宫术(DC)在子宫内膜癌诊断中的价值。

方法

本回顾性分析纳入了2000年1月1日至2010年12月31日广东省子宫内膜癌防治项目医院中3676例子宫内膜癌患者的临床病理资料。

结果

3676例子宫内膜癌患者被分为DC组(3211例)和宫腔镜检查组(465例)。与病理诊断结果相比,DC组和宫腔镜检查组的准确率分别为91.00%(2922/3211)和90.75%(422/465),差异无统计学意义(χ² = 0.030,P = 0.862)。DC组和宫腔镜检查组宫颈受累的准确率、敏感性、特异性、阳性预测值和阴性预测值分别为81.28%对86.45%(P < 0.01)、24.78%对23.68%(P > 0.05)、93.76%对98.71%(P < 0.01)、46.75%对78.26%(P < 0.01)和84.95%对86.88%(P > 0.05)。DC组腹腔细胞学阳性率为4.76%(153/3211),宫腔镜检查组为3.23%(15/465),差异无统计学意义(χ² = 2.206,P = 0.137)。DC组和宫腔镜检查组的5年总生存率(91.02%对92.03%;χ² = 0.033,P = 0.856)和5年无进展生存率(89.81%对91.83%;χ² = 1.508,P = 0.219)差异无统计学意义。

结论

宫腔镜检查及刮宫术是诊断子宫内膜癌的有效方法,尤其是宫腔镜检查在诊断宫颈受累方面更好。宫腔镜检查不会增加腹腔细胞学阳性的风险,也不会影响子宫内膜癌患者的预后。

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