摘要
目的:探讨术前B超、分段诊刮、术中肉眼观察对判断Ⅰ期子宫内膜癌肌层浸润深度的价值。方法:收集2000年1月至2008年10月在我院经手术治疗手术病理分期为Ⅰ期子宫内膜癌的患者38例,以术后病理诊断为金标准,评估术前B超、分段诊刮、术中肉眼观察对Ⅰ期子宫内膜癌肌层浸润深度的判断。结果:术前超声对肌层浸润总的诊断准确率为50%(19/38),对判断深肌层浸润的准确率为66.67%(9/12),而对浅肌层浸润的准确率判断41.67%(10/24)。术中肉眼观察对肌层浸润总的诊断准确率为84.21%(36/38),Ⅰa期、Ⅰb期、Ⅰc期的准确率分别为100%、83.33%、91.6%。比较上述两种方法在判断子宫内膜癌肌层浸润方面,术中肉眼观察判断的阳性和阴性预测值更好。术前分段诊刮对宫颈受累的诊断符合率较低,为30.74%。结论:术前B超检查结合术中肉眼观察对子宫内膜癌肌层浸润深度的判断有较重要的价值,指导术中决策;术前分段诊刮不能对肌层浸润深度作出判断,而对宫颈受累的判断仅作临床参考。
Objective To determine the value of preoperative ultrasound, diagnotic fractional curettage, intraoperative gross visual inspection in evaluating the diagnosis of myometfial invasion in endometrial carcinoma. Method Collected 38 cases of stage I endometrial carcinoma from January 2000 to October 2008 in our hospital and postoperative pathologic diagnosis was the gold standard. Preoperative B - ultrasound, sub - diagnosis scratch, and intraoperative visual observation of phase I endometrial cancer were assessed to determine the depth of myometrial invasion. Results Preoperative ultrasound myometrial invasion of the overall diagnostic accuracy was 50% （19/38） , deep myometrial invasion in judging the accuracy rate of 66. 67% （9/12） , and myometrial invasion of shallow to judge the accuracy of 41.67 % （10/24）. Intraoperative visual observation of myometrial invasion overall diagnostic accuracy was 84. 21% （36/38） , I a phase, I b phase, I c phase accuracy were 100% ,83.33% and 91.6% , respectively. Comparing the two methods in determining myometrial invasion of endometrial cancer, the intraoperative visual observation to determine the positive and negative predictive value was better. Fractional curettage diagnostic accuracy of cervical violations was the lower rate of 30.74 %. Conclusion Preoperative ultrasound combined with intraoperative visual observation of endometrial cancer to determine the depth of myometrial invasion has a more important value of intraoperarive decision - making guidance. Diagnotic fractional curettage can not judge the depth of myometrial invasion, and violation of the cervix to determine the clinical reference only.
出处
《吉林医学》
CAS
2009年第21期2610-2613,共4页
Jilin Medical Journal
关键词
子宫内膜肿瘤
子宫肌层
肿瘤浸润
Endometrial neoplasms
Myometrium
Neoplasm invasion
