细胞学检查在子宫切除或输卵管卵巢切除患者中检测子宫内膜增生及子宫内膜癌和卵巢癌的诊断价值

Diagnostic Value of Cytology in Detecting Endometrial Hyperplasia and Endometrial and Ovarian Cancers in Patients Undergoing Hysterectomy or Salpingo-Oophorectomy.

作者信息

Allameh Tajossadat, Danesh-Pour Shiva, Afshar Moghadam Nooshin, Danesh-Pour Shima

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan Iran.

出版信息

Adv Biomed Res. 2019 Mar 20;8:20. doi: 10.4103/abr.abr_191_18. eCollection 2019.

DOI:10.4103/abr.abr_191_18

PMID:31016178

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6446583/

Abstract

BACKGROUND

Ovarian cancer (OC) is one of the most common cancers among women in the world. This study aimed to compare the results of endometrial and endocervical cytology with the ultimate outcome of the uterus, ovary, and fallopian tube (derived from hysterectomy or salpingo-oophorectomy) in diagnosing endometrial hyperplasia, endometrial, and OC.

MATERIALS AND METHODS

This cross-sectional study was conducted on 30 women with endometrial hyperplasia, 90 cases of endometrial cancer, 30 cases of OC, and 30 normal controls undergoing hysterectomy or salpingo-oophorectomy referring to Al-Zahra and Shahid Beheshti Hospitals in 2015-2017. Their basic and clinical characteristics were recorded, and then, endometrial cytology was performed by a specialist and sent to a pathological center.

RESULTS

Diagnostic value of cytology showed that out of 90 individuals with endometrial cancer, 78 (86.7%) ones were positive and 12 (13.3%) were negative with sensitivity and specificity of 86.67% and 100%, respectively. Its positive predictive values (PPVs) and negative predictive values (NPVs) were 100% and 71.4% (AUC = 0.933; < 0.0001). In diagnosing endometrial hyperplasia out of 30 individuals with endometrial hyperplasia, there were 24 (80.0%) positive and 6 (20.0%) negative with sensitivity and specificity of 80.00% and 100%, respectively. Its PPVs and NPVs were 100% and 83.3%, respectively (AUC = 0.9000; < 0.0001). In diagnosing, OC cytology could not detect any one of the 30 individuals with OC, with sensitivity and specificity of 0% and 100.0%, respectively. Its PPVs and NPVs were 0% and 50%, respectively (AUC = 0.500; = 1.00).

CONCLUSION

Cytology has a good diagnostic value for detecting endometrial hyperplasia and endometrial cancer compared to pathology; however, due to very low sensitivity in detection of OC, it could not be considered as a good diagnostic tool.

摘要

背景

卵巢癌（OC）是全球女性中最常见的癌症之一。本研究旨在比较子宫内膜和宫颈细胞学检查结果与子宫、卵巢和输卵管（源自子宫切除术或输卵管卵巢切除术）的最终结果，以诊断子宫内膜增生、子宫内膜癌和卵巢癌。

材料与方法

本横断面研究对2015年至2017年转诊至阿尔扎赫拉医院和沙希德·贝赫什提医院接受子宫切除术或输卵管卵巢切除术的30例子宫内膜增生患者、90例子宫内膜癌患者、30例卵巢癌患者和30例正常对照进行。记录其基本和临床特征，然后由专科医生进行子宫内膜细胞学检查并送至病理中心。

结果

细胞学检查的诊断价值显示，90例子宫内膜癌患者中，78例（86.7%）呈阳性，12例（13.3%）呈阴性，敏感性和特异性分别为86.67%和100%。其阳性预测值（PPV）和阴性预测值（NPV）分别为100%和71.4%（AUC = 0.933；P < 0.0001）。在诊断30例子宫内膜增生患者中的子宫内膜增生时，24例（80.0%）呈阳性，6例（20.0%）呈阴性，敏感性和特异性分别为80.00%和100%。其PPV和NPV分别为100%和83.3%（AUC = 0.9000；P < 0.0001）。在诊断卵巢癌时，30例卵巢癌患者中细胞学检查未检测出任何一例，敏感性和特异性分别为0%和100.0%。其PPV和NPV分别为0%和50%（AUC = 0.500；P = 1.00）。