子宫内膜采集器在子宫内膜癌及癌前病变筛查中的应用

目的探讨子宫内膜采集器应用于子宫内膜癌及癌前病变筛查时的准确性和可行性。方法 2012年4月至2012年11月北京大学人民医院妇科收治需行宫腔镜检查的患者131例。应用子宫内膜采集器采集子宫内膜组织,随后应用宫腔镜评价标本采集范围并直视下活检内膜组织。分别组织学制片后,对比二者的病理学结果,并计算敏感性,特异性和准确率。结果满意标本采集率83.21%(109/131)。满意标本109例,其中子宫内膜癌/不典型增生14例,检出13例,采集器筛查的敏感性和特异性分别为92.9%和100.00%,准确率为99.1%。取材不满意的22例患者中,6例(4.58%)组织过少,无法制片。16例(12.21%)擦痕不能遍布整个宫腔,其中11例为双侧输卵管开口处不能见到擦痕,5例为未能进入宫腔。结论子宫内膜采集器可以用来筛查子宫内膜癌及不典型增生;但不适合用于黏膜下子宫肌瘤和子宫内膜息肉的标本采集;需扩大样本量做进一步检验。

Accuracy of endometrial sampling device in the screening of endometrial cancer

Objective To discuss the possibility of using endometrial sampling device as a screening tool to detect cancer or precancerous lesion of endometrium. Methods Endometrial sampling device was used before the hysteroseopy examination, to examine the endometrium of 131 patients from April to November, 2012. The results w ere compared with the histological results by hysteroscopy sampling. Results The qualified rate for the sampling was 83.2% （109/131）. The cancer or precancerous lesions of endometriurn were found in 14 of 109 cases. The sensitivity and specificity of cytology were 92.9% and 100.00%, respectively, and its accuracy rate was 99. 1%. We did not get qualified tissues in twentytwo patients. The reasons were the limited amount of tissue in 6 cases, unable to sample the whole cavity in 11 cases, and unable to get through the cervix in 5 cases. Conclusions The endometrial sampling device can be used in detecting the cancer or precancerous lesion of endometrium although not good enough in submucous myoma or polyps. It still needs some improvement in design and much amount of following verify.