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目的探讨宫腔镜检查用于筛查子宫内膜癌及癌前病变的临床诊断价值。方法选取2014年1月-2015年12月该院妇产科门诊收治的阴道异常出血的绝经期或绝经期后妇女105例,分别行宫腔镜检查和传统分段诊刮术,以患者最后病理检查结果作为诊断的金标准,对比宫腔镜检查和传统分段诊刮术诊断子宫内膜癌及癌前病变的灵敏度、特异度和符合率,评估宫腔镜检查筛查子宫内膜癌以及癌前病变的预测价值。结果传统分段诊刮术与病理检查诊断符合率为80.85%,宫腔镜与病理检查诊断符合率为97.44%,两组筛查结果与病理检查诊断符合率比较,差异有统计学意义(χ~2=5.01,P<0.05);宫腔镜检查诊断子宫内膜癌及癌前病变的灵敏度显著高于传统分段诊刮术(χ~2=23.71、12.38,P<0.05)。结论宫腔镜检查筛查子宫内膜癌及癌前病变的灵敏度、特异度较高,可有效提高诊断率。
Objective To investigate the value of hysteroscopy in the screening of endometrial cancer and precancerous lesions. Methods A total of 105 postmenopausal or postmenopausal women with vaginal abnormalities who were admitted to obstetrics and gynecology clinic from January 2014 to December 2015 were enrolled in this study. Hysteroscopy and traditional sectional curettage were performed respectively. The final pathology Examination results as the gold standard for diagnosis, contrast hysteroscopy and traditional segmental curettage diagnosis of endometrial cancer and precancerous lesions sensitivity, specificity and coincidence rate, assessment of hysteroscopy screening for endometrial cancer and Predictors of precancerous lesions. Results The coincidence rate of conventional segmental curettage and pathological examination was 80.85%. The coincidence rate of hysteroscopy and pathological examination was 97.44%. The coincidence rate of screening results and pathological examination between the two groups was statistically significant (χ ~ 2 = 5.01, P <0.05). The sensitivity of hysteroscopy in diagnosis of endometrial carcinoma and precancerous lesions was significantly higher than that of conventional segmental curettage (χ ~ 2 = 23.71, 12.38, P <0.05). Conclusion Hysteroscopy screening for endometrial cancer and precancerous lesions with high sensitivity and specificity can effectively improve the diagnostic rate.