论文部分内容阅读
目的 探讨宫腔镜检查对子宫内膜癌和子宫内膜癌前病变的诊断价值。方法 回顾分析 1994年 4月至 1999年 2月 2 0 6例具有临床症状伴子宫内膜癌高危因素行宫腔镜检查病例。结果 宫腔镜诊断子宫内膜癌及可疑癌 37例 (18 0 % ) ,经病理证实为癌者 2 2例 (10 7% ) ,19例进行了手术 ,术后病理证实宫颈管受侵 4例 ,未受侵 15例 ,与之相比 ,手术前宫腔镜诊断符合率为 94 7%。术中腹水细胞学检查 15例 ,阴性 13例 ,阳性 1例 ,可疑 1例。 2 0 6例中经病理证实Ⅰ～Ⅲ级非典型增生 12例 ,而宫腔镜下诊断为可疑癌 4例 ,增生 4例 ,正常或萎缩子宫内膜 3例 ,内膜结核 1例。结论 宫腔镜检查直观病灶 ,准确活检 ,适用于早期诊断 ,同时明确病灶部位和范围 ,提高宫颈管受侵与否的诊断率 ,但是宫腔镜下难以区别各类型子宫内膜增生性质
Objective To investigate the diagnostic value of hysteroscopy in the diagnosis of endometrial carcinoma and endometrial precancerous lesions. Methods From April 1994 to February 1999, 206 cases with clinical symptoms and high risk factors of endometrial cancer underwent hysteroscopy. Results Hysteroscopy diagnosed endometrial cancer and suspicious carcinoma in 37 cases (18 0%), pathologically confirmed as cancer in 22 cases (10 7%), 19 cases underwent surgery, postoperative pathology confirmed cervical canal invasion 4 Cases, no invasion of 15 cases, compared with preoperative hysteroscopy diagnosis rate of 94.7%. Intraoperative ascites cytology in 15 cases, negative in 13 cases, 1 case of positive, suspicious in 1 case. There were 12 cases diagnosed as atypical hyperplasia Ⅰ ~ Ⅲ by pathology in 2 0 6 cases, 4 cases suspicious carcinoma under hysteroscopy, 4 cases hyperplasia, 3 cases normal or atrophic endometrium and 1 case endometrial tuberculosis. Conclusion hysteroscopy visual lesions, accurate biopsy, is suitable for early diagnosis, and clear the lesion site and scope to improve the diagnosis of cervical canal invasion or not, but hysteroscopy is difficult to distinguish between various types of endometrial hyperplasia