术前病理联合血清CA125诊断子宫癌肉瘤的价值

发布时间：2018-04-16 20:07

本文选题：子宫肿瘤 + 癌肉瘤　；参考：《广东医学》2015年08期

【摘要】：目的探讨宫腔镜下活检、诊断性刮宫两种术前病理检查方法联合血清CA125在子宫癌肉瘤诊断中的价值。方法收集2000年1月至2012年1月广东省子宫内膜癌防治项目资料相对完整,经手术病理确诊的子宫癌肉瘤患者106例,对其术前检查方法进行回顾性分析。结果 (1)术前行诊断性刮宫74例,组织病理学报告为子宫癌肉瘤、其他子宫恶性肿瘤、子宫内膜不典型增生分别占35.1%、52.7%、9.5%;宫腔镜下活检11例,病理报告为子宫癌肉瘤、其他子宫恶性肿瘤、子宫内膜不典型增生分别占36.4%、45.5%、9.1%。术前诊断性刮宫与宫腔镜下活检两种方法诊断子宫癌肉瘤的符合率比较差异无统计学意义。(2)无附件转移者,术前血清CA125升高者占23.5%,有附件转移者术前CA125升高者占75.0%,两者比较差异有统计学意义,术前血清CA125升高与附件转移有关(P=0.002)。结论诊断性刮宫、宫腔镜下活检诊断子宫癌肉瘤的准确性相近;术前组织学报告大多能诊断为恶性肿瘤,但组织学分类误诊率高。术前血清CA125升高患者,应警惕附件转移的可能性。
[Abstract]:Objective to investigate the value of hysteroscopic biopsy, diagnostic curettage two preoperative pathological examination method combined with serum CA125 in the diagnosis of uterine cancer sarcoma. Methods from January 2000 to January 2012 in Guangdong Province, endometrial cancer prevention project data is relatively complete, with 106 patients with pathologically confirmed uterine carcinosarcoma, on its preoperative examination method retrospective analysis. Results (1) preoperative diagnostic curettage in 74 cases, pathological report for uterine carcinosarcoma, other malignant tumor of uterus, endometrial atypical hyperplasia accounted for 35.1%, 52.7%, 9.5%; hysteroscopic biopsy 11 cases, diagnosed as uterine carcinosarcoma, other malignant tumor of uterus, endometrial atypical hyperplasia accounted for 36.4%, 45.5%, 9.1%. in the preoperative diagnosis rate had no significant difference with curettage under hysteroscopy and biopsy of two kinds of methods in the diagnosis of uterine carcinosarcoma. (2) no attachments , preoperative serum level of CA125 was 23.5%, with attachments metastasis elevated preoperative CA125 was 75%, the difference was statistically significant, preoperative serum CA125 associated with ovarian metastasis (P=0.002). Diagnostic curettage and similar accuracy of biopsy in diagnosis of uterine carcinosarcoma under hysteroscopy; preoperative histologic report most of the diagnosis of malignant tumors, but the histological classification of high misdiagnosis rate. The preoperative serum level of CA125 patients should be alert to the possibility of the attachments.

【作者单位】：中山大学附属第三医院妇科;
【基金】：国家自然科学基金资助项目(编号:30772332) 广东省自然科学基金资助项目(编号:S2012010008640) 广东省妇幼安康工程——子宫内膜癌防治项目
【分类号】：R737.33

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