两种子宫内膜脱落细胞取材方法在筛查子宫内膜癌中的应用

Cytologic examination in detecting endometrial carcinoma by different equipment

  • 摘要: 目的: 了解瑞典欧立宫内膜吸管及宫内膜毛刷行宫腔细胞学取材在筛查子宫内膜癌方面的应用效果。方法: 先分别采用上述两种器具获取宫内膜细胞学标本,然后做诊断性刮宫行组织学病理检查,与细胞学检查结果进行比较。结果: ①观察对象共10 93例,其中应用宫内膜吸管895例,宫内膜毛刷198例,宫腔细胞学检查施行率100%,同时行诊刮术;②宫腔细胞学取材满意率:宫内膜吸管为81. 1%(726/895),宫内膜毛刷为82. 8%(164/198),两者间统计学差异无显著性(P=0.063),诊刮取材满意率93.2%;③以诊刮子宫内膜组织的病理学诊断结果为标准,宫腔取材细胞学诊断子宫内膜癌的诊断符合率为83. 3%,宫腔细胞学采用以癌为指标诊断子宫内膜癌的假阳性率0.8%,假阴性率18. 6%。结论: 应用欧立宫内膜吸管及宫内膜毛刷进行宫腔细胞学检查,两种器具在取材满意率上无差异,均具有痛苦小、出血少、器具一次性使用无交叉感染,诊断符合率较高的优点。用于人群子宫内膜癌的筛查,可减少不必要的刮宫。

     

    Abstract: Objective: To determine the efficacy of cytological examination in detecting endometrial carcinoma by two kinds of equipment. Methods: The cells of endometria were obtained by means of Ori Endometyial Sampler and Ori Endometyial Brush.Diagnostic uterine curettage was done simulfaneourly. Results: (1)1093 cases including 895 cases by Endometyial Sampler and 198 cases by Endometrial Brush were observed, the success rate of performation was 100%; (2)The satisfactory rates of specimens collected with Endometrial Sampler and Endometrial Brush were 81.1%(726/895) and 82.8%(164/198), respectively, P=0.063. Meanwhile, the rate of satisfactory samples obtained from diagnostic uterine curettage was 93.2%; ⑶When using the histological of endometrial carcinoma as the diagnostic standard, the diagnostic accordance rate of the cytology with the histological pathology was 83.3%, false positive rate and false negative rate were 0.8%, and 18.6%, respectively. Conclusion: The Ori Endometrial Sampler and Ori Endometrial Brush, used to detecting endometrial carcinoma, could collect the satisfactory specimens with high sensitivity, high specificity, high rate of diagnostic accordance rate. Besides, it was convenient and had less blood loss, with almost no pain to use these equipment. The material was used only once to avoid cross infection. Therefore, these method were safe and effective and these could be introduced into clinical application.

     

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