细胞学联合组织学在子宫内膜病变无创筛查中的应用价值

目的:探讨联合应用组织学及细胞学的方法筛查子宫内膜病变的临床应用价值。方法:选取62例有异常阴道出血或B超提示子宫内膜异常需行诊断性刮宫的妇女,术前使用一种特制的带有负压吸引装置的子宫内膜取样器进行宫腔细胞学采样,将细胞学及无创组织学的结果与诊断性刮宫后病理结果比较,分析其取材满意度、诊断符合率、出血量及疼痛程度。结果:子宫内膜取样器取材满意率为98.4%,细胞学诊断的敏感性、特异性及符合率分别达到83.3%、93.9%和91.8%;子宫内膜取样器中组织物获得率91.9%,通过取样器获得组织学的患者与其细胞学联合,诊断敏感性、特异性及准确率达到84.6%、95.8%和93.4%。子宫内膜取样器取材操作中出血量平均为(1.2±0.9)ml;诊断性刮宫取材满意率为100%,出血量平均为(6.3±8.3)ml。结论:可通过子宫内膜取样器获得子宫内膜的宫腔细胞学及组织学标本,从而做到简单、安全、可靠地筛查子宫内膜病变。

Combined application of cytology and histology in diagnosing endometrial diseases

Objective:To compare diagnostic accuracy and adequacy of endometrial sampler through which we can acquire both cytological and histological specimens with dilata-tion and curettage. Method:62 patients were diagnosed by endometrial sampler which had a special vacuum device to help gather cytological and histological specimens before D&C diagno-sis. Uterine cytological and acquisitions were categorized under five headings:unsatisfactory, normal,atypia,tumor cell suspicious and tumor cell. Histologic sections from endometrial sam-pler,together with cytology were compared with hysterectomy specimens from D&C. Chi-square, and T-test were used in the study. The sensitivity,specificity,diagnostic accuracy were calculat-ed. Result:By cytology, sensitivity, specificity, diagnostic accuracy were 83. 3%, 93. 9%, 91. 8% respectively between ES sampler and D&C,which can reach up to 84. 6%,95. 8%, 93. 4% respectively when the diagnose was associated with biopsy by the sampler. Conclusion:ES sampler and D&C showed almost equal accuracy rate in the diagnosis of endometrial pathol-ogies. ES sampler is a more economic and quick technique compared with D&C, and can be considered prior to D&C.