Value of hysteroscopy in differentiating benign and malignant endometrial lesions in middleaged and elderly patients
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摘要: 目的 探讨宫腔镜手术在中老年子宫内膜良恶性病变诊断中的应用价值。 方法 选取本院2014年1月- 2016年12月行子宫切除术者119例，根据术前诊断方法分为研究组(宫腔镜手术组)和对照组(分段诊刮组)，记录两种诊断方法和手术病理结果，比较两种方法对子宫内膜癌和癌前病变的诊断效率。 结果 研究组62例、对照组57例，两组年龄、体质量指数以及疾病分类情况差异无统计学意义(P> 0.05)；研究组对子宫内膜癌及癌前病变诊断灵敏度(91.7% vs 73.2%，P< 0.05)、阳性预测值(100.0% vs 78.9%，P< 0.05)和准确率(90.3% vs 75.4%，P< 0.05)均高于对照组；两组对子宫内膜癌及癌前病变诊断的特异度(85.7% vs 81.3%)和阴性预测值(75.0% vs 68.4%)差异无统计学意义(P> 0.05)。 结论 与常规分段诊刮方法相比，宫腔镜手术对中老年子宫内膜癌及癌前病变诊断效率更高，该方法易于掌握，对硬件设备要求低，适合基层医院开展。Abstract: Objective To investigate the value of hysteroscopy in the diagnosis of benign and malignant endometrial lesions in middle-aged and elderly patients. Methods A total of 119 middle-aged and elderly patients were selected in our hospital from January 2014 to December 2016. All cases were divided into observation group (hysteroscopic operation, n=62) and control group(fractional curettage, n=57) according to different preoperative diagnostic methods. Clinical data about patients in the two groups and the accuracy of two diagnostic methods for benign and malignant endometrial lesions were compared. Results There was no significant difference between the two groups in age, body mass index and pathological diagnosis (All P> 0.05). The sensitivity, positive predictive value and diagnosis accuracy of the observation group in the diagnosis of endometrial carcinoma and precancerous lesions were significantly higher than those of the control group (91.7% vs 73.2%, 100.0% vs 78.9%, 90.3% vs 75.4%, all P< 0.05), while the specificity and negative predictive value of the two groups showed no statistically significance (85.7% vs 81.3%, 75.0% vs 68.4%, P> 0.05, respectively). Conclusion For middle-aged and elderly patients with endometrial carcinoma and precancerous lesions, hysteroscopy improves diagnostic accuracy and helps clinicians make right decisions.
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Keywords:
- hysteroscopic surgery /
- curettage /
- endometrial carcinoma /
- middle and old aged
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