MRI和术前组织学联合对子宫内膜癌淋巴结转移高危因素的评估

发布时间：2018-06-04 15:23

  本文选题：MRI + 术前组织学　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨MRI与术前组织学联合对区分子宫内膜癌高危或低危淋巴结转移的准确性。方法:回顾性分析2013.11~2016.11于山西医科大学第一医院确诊为子宫内膜癌(Endometrial Cancer,EC)行手术治疗的134例患者。将101例行全面分期术患者的术前诊刮病理组织学结果(分级和分型)及盆腔MRI的结果(肌层浸润深度及淋巴结肿大)与最终病理进行比较。结果:MRI对宫颈受累和淋巴结(Lymph Node,LN)转移有较高特异性(Specificity,SP)和阴性预测值(Negative predictive value,NPV),术前组织学对G3和Ⅱ型内膜癌也有较高的SP和NPV。术前组织学和MRI联合识别高危患者具有较好的诊断价值(AUC=0.814),与术后病理也有良好的一致性(Kappa值=0.623)。经MRI和术前组织学联合评估均低危的39例患者,最终病理结果无盆腔或腹主动脉旁LN转移。结论:MRI和术前组织学对EC淋巴结转移危险因素的评估是有意义的。MRI和术前组织学可以较准确的识别低危患者,从而避免不必要的淋巴结切除术及术后并发症的发生。
[Abstract]:Objective: to evaluate the accuracy of MRI combined with preoperative histology in differentiating high risk or low risk lymph node metastasis from endometrial carcinoma. Methods: 134 cases of endometrial carcinoma diagnosed as Endometrial carcinoma (EC) in the first Hospital of Shanxi Medical University were analyzed retrospectively. The histopathological results (classification and classification) of preoperative curettage and the results of pelvic MRI (depth of myometrial invasion and lymphadenopathy) were compared with the final pathology. Results there was a high specificity and negative predictive value for cervical involvement and lymph node lymphatic lymph node metastasis. Preoperative histology was also associated with high SP and NPV in G3 and type 鈪，

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