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探讨宫腔镜检查在子宫内膜癌诊断中的价值。方法 :经手术治疗的子宫内膜癌共 10 2例分为两组 :(1)宫腔镜检查组 (39例 ) ,在宫腔镜下行分段诊刮术 ;(2 )单纯分段诊刮组 (6 3例 )。比较两组术前后宫颈受累情况的诊断符合率及开腹手术时腹水细胞学检查的结果。结果 :两组患者的年龄、临床分期、病理分级及组织学类型差异无显著性 ,宫腔镜检查组诊断宫颈受累的准确率为 97.4% (38/ 39) ,明显高于单纯分段诊刮组 (76 .2 % ,48/ 6 3) ,其假阳性率 (0 / 35 )明显低于单纯分段诊刮组 (2 1.6 % ,11/ 5 5 ) (P值均 <0 .0 1) ,两组患者均无腹水 ,有 84.3 %(86 / 10 2 )在开腹手术时行腹腔洗液细胞学检查。宫腔镜检查组腹腔洗液细胞学阳性率为 8.8% (3/ 34) ,单纯分段诊刮组为 13.5 % (7/ 5 2 ) ,两组差异无显著性 (P >0 .0 5 )。结论 :宫腔镜检查可提高子宫内膜癌诊断的准确性 ,能较确切地了解宫颈是否受累 ,同时可能并不增加肿瘤细胞扩散的机会 ,对可疑宫内病变者应在宫腔镜检查下分段诊刮。
To investigate the value of hysteroscopy in the diagnosis of endometrial cancer. Methods: A total of 102 cases of endometrial cancer undergoing surgical treatment were divided into two groups: (1) hysteroscopy group (39 cases) underwent hysteroscopic segmental curettage; (2) simple segmental diagnosis Scratch group (63 cases). The diagnostic coincidence rate of cervical involvement before and after operation and the results of ascites cytology during laparotomy were compared between the two groups. Results: There was no significant difference in age, clinical stage, histological grade and histological type between the two groups. The diagnostic accuracy of hysteroscopy in diagnosing cervical involvement was 97.4% (38/39), which was significantly higher than that of simple segmental curettage Group (76.2%, 48/6 3), the false positive rate (0/35) was significantly lower than the simple segmental curettage group (2 1.6%, 11/5 5) (P <0.01 ). No ascites was found in both groups, and 84.3% (86/102) performed cytological examination of abdominal cavity during open surgery. The positive rate of intrauterine fluid cytology in hysteroscopy group was 8.8% (3/34) and that in simple segmental curettage group was 13.5% (7/52), there was no significant difference between the two groups (P> 0.05) ). Conclusion: Hysteroscopy can improve the accuracy of diagnosis of endometrial cancer, can more accurately understand the cervical involvement, and may not increase the chance of tumor cell proliferation, suspected intrauterine lesions should be under hysteroscopy Fractional curettage.