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目的评估微量子宫内膜活检标本在子宫内膜癌及癌前病变筛查中的应用价值。方法收集北京大学人民医院及北京市大兴区人民医院子宫内膜活检标本589例,分别采用环状微量子宫内膜取样器以及分段诊刮获取子宫内膜组织,进行病理学诊断,观察微量子宫内膜活检取样合格率,及其与子宫内膜厚度、年龄的关系,并分析微量子宫内膜活检在子宫内膜癌及癌前病变筛查中的敏感度及特异性,筛选其相对适用人群。结果两家医院微量子宫内膜活检取样合格率为71.5%(421/589),子宫内膜较厚(≥5 mm)、年龄较小(<50岁)的患者更易获得合格的微量子宫内膜活检标本;在微量子宫内膜活检取样合格的标本中检出子宫内膜癌及癌前病变55例,与分段诊刮比较其敏感性为75.3%(55/73),特异性为99.4%(332/334)。结论微量子宫内膜活检标本合格率仍有待提高,相对适用于年轻及子宫内膜较厚的人群,但在取样合格的标本中,其筛查子宫内膜癌及癌前病变特异度较高,表明采用微量子宫内膜活检可以作为高危人群子宫内膜癌筛查的备选方法。
Objective To evaluate the value of micro-endometrial biopsy in the screening of endometrial carcinoma and precancerous lesions. Methods 589 cases of endometrial biopsy specimens collected from People ’s Hospital of Peking University and People’ s Hospital of Daxing District of Beijing were collected. Endometrial tissues were obtained by ring - shaped microendometrial endometrial sampling and sectional curettage respectively. The pathological diagnosis was performed and the uterus Endometrial biopsy sampling pass rate, and its relationship with endometrial thickness, age, and analysis of micro-endometrial biopsy in screening of endometrial cancer and precancerous lesions in the sensitivity and specificity, screening of its relatively applicable population . Results The qualified rate of microscopic endometrial biopsy in both hospitals was 71.5% (421/589), the patients with thick endometrium (≥5 mm) and younger (<50 years) were more likely to receive qualified endometrial micro-endometrium 55 cases of endometrial carcinoma and precancerous lesion were detected in the sample of qualified micro endometrial biopsy samples, the sensitivity was 75.3% (55/73) compared with that of sub-curettage, and the specificity was 99.4% (332/334). Conclusion The microbiological endometrial biopsy specimens pass rate is still to be improved, relatively suitable for young and endometrial thick people, but in the sampling of qualified specimens, screening for endometrial cancer and precancerous lesions higher specificity, It shows that micro-endometrial biopsy can be used as an alternative method for screening endometrial cancer in high-risk groups.