子宫内膜癌围手术期评估与术后病理的对比研究

发布时间：2018-05-26 01:48

本文选题：子宫内膜癌 + 术前评估　；参考：《浙江预防医学》2014年12期

【摘要】：目的通过对1 229例子宫内膜癌病例进行回顾性分析,比较手术前后评估结果与术后病理结果符合率,为临床围手术期评估提供依据。方法收集2000—2012年浙江大学附属妇产科医院收治的经病理确诊,且资料完整的1 229例子宫内膜癌病例,以手术切除的子宫标本病理诊断为"金标准",与围手术期评估结果进行比较。结果子宫内膜腺癌术前术后符合率为75.59%,Kappa值为0.21(95%CI:0.15~0.27)。非子宫内膜样腺癌术前与术后符合率为89.99%,Kappa值为0.41(95%CI:0.32~0.49)。腺鳞癌术前术后诊断符合率为97.40%,Kappa值为0.10(95%CI:-0.04~0.24)。术前组织病理学分级与术后病理分级符合率为69.57%,加权Kappa值为0.50(95%CI:0.46~0.55)。B超提示宫颈受累与术后病理提示宫颈受累符合率为43.62%,Kappa(95%CI)为-0.01(-0.04~0.03)。CT提示宫颈受累与术后病理提示宫颈受累符合率为65.32%,Kappa(95%CI)为0.26(0.20~0.32)。淋巴结阳性率随手术病理分期的升高而增高(P0.01)。结论子宫内膜癌的部分高危因素术前难以准确判断,对于子宫内膜癌患者,应行全面分期手术,以改善预后。
[Abstract]:Objective to analyze 1 229 cases of endometrial carcinoma and compare the results before and after operation with postoperative pathological results in order to provide basis for clinical perioperative evaluation. Methods A total of 1 229 cases of endometrial carcinoma with complete data were collected from 2000 to 2012 in the affiliated Obstetrics and Gynecology Hospital of Zhejiang University. The pathological diagnosis of surgically resected uterine specimens was compared with the results of perioperative evaluation. Results the preoperative and postoperative coincidence rate of endometrial adenocarcinoma was 75.59 and the Kappa value was 0.21 ~ 95% CI: 0.15 ~ 0.27%. The coincidence rate before and after operation of non-endometrial adenocarcinoma was 89.99 and the Kappa value was 0.41 卤95, CI: 0.32 and 0.49%. The preoperative and postoperative diagnostic coincidence rate of adenosquamous carcinoma was 97.40% and the Kappa value was 0.10 ~ 95% CI: -0.04% 0.24%. The coincidence rate of preoperative histopathological grade and postoperative pathological grade was 69.57, and the weighted Kappa value was 0.5095% (CI: 0.46) 0.550.The coincidence rate of B ultrasound between cervical involvement and postoperative pathological indication was -0.01- 0.040.03.CT indicated that the coincidence rate of cervical involvement and postoperative pathology was 65.32kappa 95CI (0.260.200.200.32). The positive rate of lymph nodes increased with the increase of pathological stage (P 0.01). Conclusion it is difficult to accurately judge some high risk factors of endometrial carcinoma before operation.
【作者单位】：浙江大学医学院附属妇产科医院;奉化市人民医院;
【基金】：浙江省自然科学基金资助(LY13H160002)
【分类号】：R737.33

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