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目的 探讨宫腔镜辅助下分段诊断性刮宫 (诊刮 )术诊断子宫内膜癌的临床应用价值。方法 子宫内膜癌患者 15 6例 ,分为单纯分段诊刮 (A)组 93例 ,及宫腔镜辅助下的分段诊刮 (B)组 63例 ,比较两组术前诊断子宫内膜癌的准确率。结果 A组手术病理分期与临床分期相比 ,期别提高的百分率为 3 4% ( 3 1/ 92 ) ,期别降低的百分率为 15 % ( 14/ 92 ) ,对宫颈受累估计的准确率为 75 % ( 68/ 91) ,腹腔洗液细胞学阳性率为 3 2 % ( 2 3 / 71) ;B组分别为 43 % ( 2 7/ 63 )、3 % ( 2 / 63 )、90 % ( 5 6/ 62 )和 3 5 % ( 18/5 1)。两组间手术病理分期与临床分期相比期别提高的百分率及腹腔洗液细胞学阳性率比较 ,差异无显著性 (P >0 0 5 ) ;而两组间手术病理分期与临床分期相比期别降低的百分率及对宫颈受累估计的准确率比较 ,差异有显著性 (P <0 0 5 )。结论 宫腔镜能较确切了解子宫内膜癌患者宫颈受累情况 ,提高了在其辅助下分段诊刮术前诊断子宫内膜的准确率 ,且不增加患者腹腔洗液细胞学检查的阳性率
Objective To investigate the clinical value of hysteroscopy-assisted segmented diagnostic curettage in the diagnosis of endometrial cancer. Methods A total of 156 patients with endometrial carcinoma were divided into three groups: group A (93 cases) and group A (group B) with hysteroscopy (group B). The preoperative diagnosis of uterus Membrane cancer accuracy. Results The pathological staging of group A was 34% (31/92) compared with clinical stage, and the percentage of reduction was 15% (14/92). The accuracy rate of cervical involvement was The positive rate of cytology in abdominal cavity was 32% (2/71) in group B, 43% (2/63), 3% (2/63) and 90% in group B 5 6/62) and 35% (18/5 1). There was no significant difference between the two groups in the percentages of improvement of the pathological stage and the clinical staging and the positive rate of cytology in the abdominal cavity (P> 0.05). However, compared with the clinical staging The difference of the percentage of reduction and the accuracy of cervical involvement estimation showed significant difference (P <0.05). Conclusion Hysteroscopy can accurately understand the status of cervical involvement in patients with endometrial cancer and improve the accuracy of the diagnosis of endometrium before the diagnosis of segmental curettage with the help of hysteroscopy without increasing the positive rate of cytology in abdominal cavity