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目的通过大样本人群调查评估阴道超声(transvaginal sonography,TVS)联合宫腔细胞学检查在筛查子宫内膜癌中的应用价值。方法2004年6～12月对3308例未发现恶性肿瘤的妇女进行问卷调查,对有不规则阴道流血、阴道排液、月经周期缩短﹤20d、经期延长﹥7d或具有子宫内膜癌高危因素的妇女行TVS检查;对绝经后子宫内膜厚度≥5mm或未绝经子宫内膜厚度≥10mm的妇女行宫腔细胞学检查;对宫腔细胞学诊断为癌或癌前病变及宫腔细胞学取材不满意的妇女行分段诊断性刮宫术。2006年6～12月对以上排除子宫内膜癌的3305例健康妇女再次进行问卷调查,有症状或有高危因素者行TVS检查,子宫内膜厚度异常者行宫腔细胞学检查,宫腔细胞学检查异常或取材不满意者行分段诊刮术。结果第1次调查共有436例妇女行TVS检查,120例妇女行宫腔细胞学检查,36例行分段诊刮术,其中2例确诊为子宫内膜癌,1例确诊为子宫内膜不典型增生。2年后对以上排除子宫内膜癌的健康妇女再次进行调查,未发现1例子宫内膜癌及癌前病变。TVS联合宫腔细胞学检查在人群中筛查子宫内膜癌有效减少了不必要的诊刮术。结论TVS联合宫腔细胞学检查在人群中筛查子宫内膜癌可有效减少有创检查,减少受检查者痛苦,节约医疗投入,值得推广使用。
Objective To evaluate the value of transvaginal sonography (TVS) combined with uterine cytology in the screening of endometrial cancer through large sample population survey. Methods A total of 3 088 women with no malignant tumors were surveyed from June 2004 to December 2004. The results of questionnaire survey included irregular vaginal bleeding, vaginal discharge, shortened menstrual cycle <20 days, prolonged menstrual period> 7 days or high risk of endometrial cancer Women line TVS examination; postmenopausal endometrial thickness ≥ 5mm or uterine endometrial thickness ≥ 10mm of uterine cytological examination; uterine cytology diagnosis of cancer or precancerous lesions and uterine cytology are not drawn Satisfactory women segmented diagnostic curettage. From December 2006 to December 2006, 3305 healthy women who excluded endometrial cancer were surveyed again. All the patients with symptoms or high risk factors underwent TVS examination. The patients with abnormal endometrial thickness underwent uterine cytology and uterine cytology Check abnormal or not satisfied with the line sub-curettage. Results A total of 436 women underwent TVS in the first survey. Uterine cytology was performed in 120 women and sub-curettage was performed in 36 women. Two of them were diagnosed as endometrial cancer and one was diagnosed as endometrial atypical Hyperplasia. Two years later, more than the exclusion of endometrial cancer healthy women were investigated again, found no endometrial cancer and precancerous lesions. TVS combined uterine cytology screening for endometrial cancer in the population effectively reduces unnecessary curettage. Conclusion TVS combined uterine cytology screening of endometrial cancer in the crowd can effectively reduce the invasive examination, reduce the pain of the examiner, saving medical investment, it is worth promoting the use of.