经阴道彩色多普勒超声用于子宫内膜癌病理分级的价值

目的 评价经阴道彩色多普勒超声用于子宫内膜癌病理分级的价值。方法 以68例经组织病理学确诊的子宫内膜癌患者为研究对象。全部患者均接受经阴道彩色多普勒超声检查，以术后组织病理学分析结果为金标准，分析彩色多普勒超声检测子宫肌层浸润的准确度、灵敏度、特异度、阳性预测值和阴性预测值。结果 经阴道彩色多普勒超声检测子宫内膜癌患者子宫肌层浸润的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为70.0%、67.9%、75.7%、61.3%和69.1%。子宫内膜癌侵犯子宫肌层 ≤ 50%的子宫内膜癌患者左、右侧子宫动脉阻力指数均显著高于子宫肌层浸润 > 50%的患者（均P < 0.01）；子宫内膜癌患者肿瘤分级越低，其左、右侧子宫动脉阻力指数越高（均P < 0.05）。结论 经阴道彩色多普勒超声评价子宫内膜癌患者子宫肌层浸润准确度较高，可作为一种子宫内膜癌患者术前病理分级的无创工具。

Value of transvaginal color Doppler ultrasonography for pathologic grading of endometrial cancer

Objective To evaluate the value of transvaginal color Doppler ultrasonography for pathologic grading of endometrial cancer.Methods A total of 68 patients with histopathologic diagnosis of endometrial cancer were recruited as study subjects, and all patients underwent transvaginal color Doppler ultrasonography. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of transvaginal color Doppler ultrasonography for identification of myometrial invasion by endometrial cancer were evaluated among endometrial cancer patients with postoperative histopathological examinations as a gold standard.Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transvaginal color Doppler ultrasonography were 70.0%, 67.9%, 75.7%, 61.3% and 69.1% for the detection of myometrial invasion by endometrial cancer, respectively. The resistance index values of left and right uterine arteries were both significantly higher in endometrial cancer patients with myometrial invasion ≤ 50% than those with myometrial invasion > 50% (P < 0.01), and the resistance index values of left and right uterine arteries increased with the reduced tumor grade among endometrial cancer patients (P < 0.05).Conclusion Transvaginal color Doppler ultrasonography shows a high accuracy for identification of myometrial invasion among endometrial cancer patients, which may be used as a non-invasive tool for preoperative pathologic grading of endometrial cancer.