Department of Obstetrics and Gynecology, School of Medicine, Cheeloo College of Medicine, Shandong University (Drs. Liu, Kong, Lv, and Yan); Center for Reproductive Medicine, Reproductive Hospital affliated to Shandong University, Cheeloo College of Medicine, Shandong University (Drs. Liu, Song, F. Zhang, Kong, Lv, and Yan); National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan (Drs. Liu, Song, F. Zhang, Kong, Lv, and Yan); The Key Laboratory for Reproductive Endocrinology Ministry of Education, Jinan (Drs. Liu, Song, F. Zhang, Kong, Lv, and Yan); Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, (Drs. Liu, Song, F. Zhang, Kong, Lv, and Yan); Department of Reproductive Medicine, People's Hospital of Rizhao, Rizhao, (Dr. Liu).
Center for Reproductive Medicine, Reproductive Hospital affliated to Shandong University, Cheeloo College of Medicine, Shandong University (Drs. Liu, Song, F. Zhang, Kong, Lv, and Yan); National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan (Drs. Liu, Song, F. Zhang, Kong, Lv, and Yan); The Key Laboratory for Reproductive Endocrinology Ministry of Education, Jinan (Drs. Liu, Song, F. Zhang, Kong, Lv, and Yan); Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, (Drs. Liu, Song, F. Zhang, Kong, Lv, and Yan).
J Minim Invasive Gynecol. 2020 Jul-Aug;27(5):1127-1132. doi: 10.1016/j.jmig.2019.08.035. Epub 2020 Mar 30.
To develop a new hysteroscopic morphologic scoring system to diagnose chronic endometritis (CE).
Prospective study.
Medical hysteroscopy office.
In total, 320 patients underwent hysteroscopy, dilation and curettage, and endometrial biopsies from February 2017 to June 2018 with the intention of undergoing assisted reproductive technology treatment because of infertility or recurrent miscarriage.
All patients underwent hysteroscopy, dilation and curettage, and endometrial biopsies for histologic examination and were classified according to the new hysteroscopic morphologic scoring system.
Of the 320 patients, 164 received a diagnosis of CE by histology (group A), whereas 156 patients were found not to have CE (group B). A total of 116 patients were diagnosed by our hysteroscopy scoring system to have CE, and 204 patients did not have CE. The scoring system showed a sensitivity and specificity of 62.8% and 91.7%, respectively. The positive predictive values and negative predictive values were 88.8% and 70.1%, respectively. Receiver operating characteristic analysis showed a cutoff value of >2 and an area under the curve of 0.823. Hysteroscopic and histologic grading showed moderate agreement (κ index = 0.529).
Our hysteroscopic scoring system has a high sensitivity and specificity for CE; it is hoped that its use can reduce interobserver variability. Future clinical studies are warranted to confirm the validity and clinical applicability of the proposed hysteroscopic morphologic scoring system for CE.
开发一种新的宫腔镜形态学评分系统，以诊断慢性子宫内膜炎（CE）。
前瞻性研究。
医学宫腔镜诊室。
共有 320 名患者因不孕或反复流产而接受宫腔镜检查、扩张和刮宫以及子宫内膜活检，以接受辅助生殖技术治疗。
所有患者均接受宫腔镜检查、扩张和刮宫以及子宫内膜活检，以进行组织学检查，并根据新的宫腔镜形态学评分系统进行分类。
在 320 名患者中，164 名患者的组织学诊断为 CE（A 组），而 156 名患者未被诊断为 CE（B 组）。我们的宫腔镜评分系统共诊断 116 例 CE 患者和 204 例非 CE 患者。评分系统的敏感性和特异性分别为 62.8%和 91.7%。阳性预测值和阴性预测值分别为 88.8%和 70.1%。受试者工作特征分析显示，截断值>2，曲线下面积为 0.823。宫腔镜和组织学分级显示中度一致性（κ 指数=0.529）。
我们的宫腔镜评分系统对 CE 具有较高的敏感性和特异性；希望它的使用可以减少观察者间的变异性。未来的临床研究需要证实所提出的 CE 宫腔镜形态学评分系统的有效性和临床适用性。
