子宫内膜细胞学检查在绝经后女性中的应用价值

发布时间：2018-04-28 04:57

  本文选题：子宫内膜癌 + 子宫内膜细胞学检查　； 参考：《实用妇产科杂志》2015年07期

【摘要】：目的:评价绝经后女性子宫内膜细胞学取材满意度和应用子宫内膜细胞学检查(ECT)诊断子宫内膜癌及癌前病变的准确性。方法:1045例绝经后女性采用子宫内膜细胞学取材器(SAP-1)刷取细胞学标本,222例进行宫腔镜下活检或分段诊刮(DC)术或子宫全切除术获取组织标本。比较两种方法采集标本的满意度情况,及绝经年限和子宫内膜厚度对两种取材法标本满意度的影响,另对ECT的诊断效能进行判断。结果:11045例细胞学标本中仅39例(3.7%)不充分,222例女性子宫内膜组织学标本中82例(36.9%)不充分,两者差异有统计学意义(P0.05)。2细胞学标本充分组和不充分组病例的绝经年限、子宫内膜厚度的均值比较,差异均无统计学意义(P0.05)。组织学标本充分组与不充分组病例的绝经年限、子宫内膜厚度的均值比较,差异有统计学意义(P0.05),组织学不充分组绝经年限≥10年和子宫内膜厚度≤4 mm的病例更多见(P0.05)。3ECT检查诊断绝经后女性子宫内膜癌及不典型增生的准确度是93.4%,敏感度、特异度、阳性预测值、阴性预测值分别为72.4%、99.1%、95.5%、93.0%。结论:细胞学取材术比组织学取材能提供更充分的标本,ECT可能成为筛查绝经后女性子宫内膜癌及癌前病变可靠的方法。
[Abstract]:Objective: to evaluate the degree of satisfaction of endometrial cytology in postmenopausal women and the accuracy of endometrial cytology in the diagnosis of endometrial carcinoma and precancerous lesions. Methods one hundred and forty-five postmenopausal women were brushed by endometrial cytology (SAP-1) to obtain tissue specimens from 222 cases of cytological specimens obtained by hysteroscopic biopsy or segmental curettage or total hysterectomy. The degree of satisfaction of the two methods was compared, and the influence of menopausal age and endometrial thickness on the satisfaction of the two methods was compared. The diagnostic efficacy of ECT was also evaluated. Results only 39 out of 11 045 cytological specimens were inadequate and 82 of 222 female endometrial specimens were not adequate. The difference between them was statistically significant (P 0.05.2). There was no significant difference in endometrial thickness between the two groups (P 0.05). The mean value of endometrial thickness and menopausal age of patients with adequate histological specimen and inadequate group were compared. The difference was statistically significant (P 0.05). The accuracy of P0.05 + 3 ECT in diagnosing postmenopausal women endometrial carcinoma and atypical hyperplasia was 93. 4% with sensitivity and specificity in the cases with menopausal age 鈮，

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