摘要
目的探讨宫腔镜在子宫内膜癌临床分期诊断中的应用价值。方法将138例子宫内膜癌患者根据术前检查方法不同分为宫腔镜组(n=78)和传统组(n=60),其中宫腔镜组患者给予宫腔镜辅助诊刮术,传统组患者给予传统诊刮术,观察比较两组患者的诊断准确度及腹腔冲洗液中肿瘤细胞阳性率。结果宫腔镜辅助诊刮术诊断子宫内膜癌临床分期的准确度为88.46%(69/78),明显高于传统诊刮术的70.00%(42/60),差异有统计学意义(P﹤0.01)。宫腔镜辅助诊刮术术前诊断临床分期与术后病理分期的Kappa值为0.768,一致性极佳;传统诊刮术术前诊断临床分期与术后病理分期的Kappa值为0.413,一致性较好。宫腔镜组患者腹腔冲洗液中肿瘤细胞阳性率为6.41%(5/78),与传统组的11.67%(7/60)比较,差异无统计学意义(P﹥0.05)。结论宫腔镜在子宫内膜癌临床分期诊断中有较好的应用价值,可提高术前诊断准确度,对肿瘤细胞播散的发生无明显影响。
Objective To explore the application value of hysteroscopy in clinical stage diagnosis of endometrial cancer.Method The research included 138 patients with endometrial cancer that were divided as hysteroscopy group(n=78)and traditional group(n=60),according to different preoperative examinations,the hysteroscopy group was given hysteroscopy-assisted curettage,while the traditional group was administered with traditional curettage,the diagnostic accuracy and positive rate of tumor cells assessed by peritoneal washing cytology in the two groups were observed.Result The diagnostic accuracy of hysteroscopy-assisted curettage in determining the clinical stage of endometrial cancer was 88.46%(69/78),which was significantly higher than that of traditional group at 70.00%(42/60),the difference was statistically significant(P<0.01).The Kappa value of preoperative diagnosis of clinical staging by hysteroscopy-assisted curettage and postoperative pathological staging was 0.768,indicating a fairly good consistency;and the Kappa value of preoperative diagnosis of clinical staging by traditional curettage and postoperative pathological staging in traditional group was 0.413,which was on a moderate level.The positive rates of cancer cells in peritoneal washing cytology in hysteroscopy group was 6.41%(5/78),which was similar to the 11.67%(7/60)in traditional group,with no significant differences noted(P>0.05).Conclusion Hysteroscopy is highly applicable in determining the clinical stage of endometrial cancer,with improved preoperative diagnostic accuracy,and imposes no obvious influence on the dissemination of cancer cells.
作者
谢祖婵
李奔奔
刘梅
XIE Zuchan;LI Benben;LIU Mei(Department of Gynecology,the First People’s Hospital of Qinzhou,Qinzhou 535000,Guangxi,China)
出处
《癌症进展》
2019年第18期2140-2143,共4页
Oncology Progress
关键词
宫腔镜
子宫内膜癌
应用价值
hysteroscopy
endometrial cancer
application value
