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手动负压吸引术与锐性金属刮宫术获取的组织用于异常子宫出血女性子宫内膜病理的比较

Comparison of Endometrial Pathology between Tissues Obtained from Manual Vacuum Aspiration and Sharp Metal Curettage in Women with Abnormal Uterine Bleeding.

作者信息

Sirimai Korakot, Lertbunnaphong Tripop, Malakorn Kitti, Warnnissorn Malee

出版信息

J Med Assoc Thai. 2016 Feb;99(2):111-8.

Abstract

OBJECTIVE

To study the correlation of endometrial pathology, which were derived from manual vacuum aspiration (MVA) and sharp metal curettage (SMC).

MATERIAL AND METHOD

Women aged over 35 years old who presented with abnormal uterine bleeding were enrolled. Endometrial biopsy using MVA and sharp metal curettage under paracervical nerve block were performed, respectively. Correlation of endometrial pathology from both methods and correlation between endometrial pathology from MVA and the most severe pathology were analyzed using Kappa statistics.

RESULTS

One hundred and thirty two women were enrolled Nine cases were drop out because of inability to pass the MVA's cannula through the cervical os. Mean age was 49.3 ± 8.5 years old. Mean BMI was 25.1 ± 4 kg/m². Pathological correspondence between tissue obtained from MVA and sharp metal curette was 64.2% and the Kappa agreement was 0.56 (K0 = 0.56, p-value < 0.05). Pathological correspondence between tissue obtained from MVA and the most severe pathology was 92.7% and the Kappa.agreement was 0.86 (K = 0.86, p-value < 0.05). MVA could diagnose all cases of malignancy and endometrial hyperplasia.

CONCLUSION

Manual vacuum aspiration (MVA) can be used as an alternative diagnostic procedure in women with abnormal uterine bleeding.

摘要

目的

研究通过手动真空吸引术(MVA)和金属锐性刮宫术(SMC)获取的子宫内膜病理结果之间的相关性。

材料与方法

纳入年龄超过35岁、出现子宫异常出血的女性。分别采用MVA和在宫颈旁神经阻滞下进行金属锐性刮宫术获取子宫内膜组织。使用Kappa统计分析两种方法所获子宫内膜病理结果的相关性以及MVA所获子宫内膜病理结果与最严重病理结果之间的相关性。

结果

共纳入132名女性,9例因MVA套管无法通过宫颈口而退出研究。平均年龄为49.3±8.5岁。平均体重指数为25.1±4kg/m²。MVA与金属锐性刮宫术所获组织的病理符合率为64.2%,Kappa一致性为0.56(K0=0.56,p值<0.05)。MVA与最严重病理结果的病理符合率为92.7%,Kappa一致性为0.86(K=0.86,p值<0.05)。MVA能够诊断所有恶性肿瘤和子宫内膜增生病例。

结论

手动真空吸引术(MVA)可作为子宫异常出血女性的一种替代诊断方法。

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