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目的:研究经阴道超声检查与转录因子(twist)表达在早期子宫内膜癌诊断、转移中的应用价值。方法:选取本院2014年10月至2015年8月收治的56例子宫内膜癌患者,均接受手术治疗并经手术病理结果最终确诊。以手术病理结果作为标准,患者术前均接受阴道超声检查和twist阳性表达检测,参照标准分析其诊断效果。结果:经阴道超声诊断准确率为83.93%,其中Ia期、Ic期诊断准确度分别为87.50%、82.35%,肿瘤转移诊断准确率为80.00%,差异均无统计学意义(P>0.05),但Ib期诊断出现5例漏诊,诊断准确率83.87%,较手术病理结果低,差异具有统计学意义(P<0.05);经twist免疫组化阳性检出率66.07%,高于正常子宫内膜组织的阳性表达率4.44%,两组比较,差异具有统计学意义(P<0.05)。结论:术前经阴道超声能较好的诊断子宫内膜癌和观察肿瘤浸润及转移情况,twist免疫组化检测在子宫内膜癌患者中阳性表达率较高,twist阳性表达预示着子宫内膜癌的高风险可能,临床应用中可结合阴道超声和twist表达检测结果对子宫内膜癌进行早期诊断和转移观察。
Objective: To study the value of transvaginal sonography and twist expression in the diagnosis and metastasis of early endometrial carcinoma. Methods: Fifty-six patients with endometrial cancer who were treated in our hospital from October 2014 to August 2015 were enrolled in this study. All patients underwent surgical treatment and finally confirmed by pathological findings. Surgical pathology results as a standard, patients were preoperative vaginal ultrasound and twist positive expression was detected, the reference standard analysis of its diagnostic effect. Results: The accuracy of transvaginal sonography was 83.93%. The diagnostic accuracy of Ia and Ic were 87.50% and 82.35% respectively, and the diagnostic accuracy of tumor metastasis was 80.00% (P <0.05) However, there were 5 missed diagnoses in Ib and 83.87% in diagnoses, which was lower than that in surgical pathology (P <0.05). The positive rate by twist immunohistochemistry was 66.07%, which was higher than that in normal endometrium The positive rate was 4.44%. There was significant difference between the two groups (P <0.05). Conclusion: Transvaginal ultrasonography can diagnose endometrial carcinoma well and observe tumor invasion and metastasis before operation. The positive expression rate of twist immunohistochemistry in endometrial carcinoma patients is high, and the positive expression of twist indicates the endometrium The high risk of cancer may, in clinical applications can be combined with vaginal ultrasound and twist expression test results of early diagnosis and metastasis of endometrial cancer observation.