阴道超声和宫腔镜诊断子宫内膜癌对比研究

目的研究阴道超声和宫腔镜在诊断子宫内膜癌上的临床价值,比较2者的差异,评价2者在子宫内膜癌诊断上的优势。方法以2008年4月至2012年8月2家医院收治的不规则子宫出血患者289例为对象,通过阴道超声和宫腔镜检查的结果,对比分析出各自在诊断子宫内膜癌中的不同点。结果 289例患者中共诊断162例子宫内膜癌,其中阴道超声准确诊断子宫内膜癌132例,准确率为80.97%;宫腔镜准确诊断子宫内膜癌150例,准确率为92.39%;宫腔镜诊断准确率优于阴道超声（P〈0.05）。阴道超声诊断子宫内膜癌灵敏度为81.48%,特异度为80.31%,假阴性率为18.52%,假阳性率为19.69%,总的阳性和阴性预测值分别是84.08%和77.27%,约登指数为61.79%;宫腔镜诊断子宫内膜癌灵敏度为92.59%,特异度为92.13%,假阴性率为7.41%,假阳性率为7.87%,总的阳性和阴性预测值分别是93.75%和90.70%,约登指数为84.72%。结论经阴道超声和宫腔镜均可以诊断子宫内膜癌,但宫腔镜检查有更高的敏感性和准确性。

Comparative research on transvaginal ultrasonography and hysteroscopy in diagnosis of endometrial cancer

Objective To evaluate the clinical application values of transvaginal ultrasonography（ TVUS） and hysteroscopy in diagnosis of endometrial cancer. Methods A total of 289 abnormal uterine bleeding patients who had been examined by TVUS or hysteroscopy were investigated from April 2008 to August 2012. Results Among the 289 patients,162 patients were diagnosed with endometrial cancer,and 132 cases by means of TVUS and others by hysteroscopy.Their accuracy percents were 80. 97% and 92. 39% respectively,which meant the accuracy of hysteroscopy was superior to TVUS（ P〈0. 05）. The sensitivity,specificity,false-negative rate,false-positive rate,positive predictive value,negative predictive value and Youden＇s index of endometrial carcinoma detection were 81. 48%,80. 31%,18. 52%,19. 69%,84. 08%,77. 27% and 61. 79 by TVUS,respectively,vs 92. 59%,92. 13%,7. 41%,7. 87%,93. 75%,90. 70%,84.72 by hysteroscopy,respectively. Conclusions Hysteroscopy detection of endometrial carcinoma correlates with TVUS,and its sensitivity and accuracy are superior to TVUS.