摘要
目的 :评价 B超、宫腔镜和诊刮在未绝经的子宫内膜癌的诊断作用。方法 :10 3例原发性子宫内膜癌 ,2 3～5 5岁 ,未绝经。超声诊断后 ,宫腔镜检查并取内膜活检。结果 :不规则阴道出血 84例 (81.6 % ) ,所有病例内膜厚度≥ 5mm,平均内膜厚度 (9.3± 5 .6 ) mm。多数患者被按良性病变治疗 2～ 9个月后 ,才进行诊刮或宫腔镜检查。诊刮、宫腔镜阳性率分别为 86 .5 %、10 0 %。症状出现后 ,3个月内确诊比例为 35 .9% ,3～ 9个月、9个月以后的比例分别为 2 5 .2 %、38.8%。结论 :绝经前子宫内膜癌的主要症状是不规则阴道出血、年轻的患者 ,出现症状后到确诊的时间较长 ;B超不能代替诊刮和宫腔镜。
Objective:To evaluate the diagnostic value of ultrasound,diagnostic curettage and hysteroscopy in patients with endometrial carcinoma before menopause.Methods:103 cases with primary endometrial cancer varied from 23 years old to 55 years old before menopause. All cases were performed ultrasound examination within 1 month when the abnormal symptoms appeared. Directed biopsy was performed during hysteroscopy. Cases in negative result after diagnostic curetting should be performed hysteroscopy. The clinical features were compared with the reports of ultrasound and hysteroscopy.Results:84 cases (81.6%) showed irregular vaginal bleeding with staging difference from Ⅰ～Ⅳ. The endometrial thickness was more than 5 mm in all cases and the average thickness was (9.3±5.6) mm. Most of the patients had been treated as benign disease for 2 to 9 months or even longer before diagnosis. The accuracy of biopsy and hysteroscopy combined with biopsy were 86.5% and 100%,respectively. The percentages of the case diagnosed definitely within 3 months,3 to 9 months and longer than 9 months were 35.9%,25.2% and 38.8%,respectively.Conclusion:The chief symptom of endometrial cancer before menopause is irregular vaginal bleeding. It is long until they were diagnosed in young patients. Ultrasound reports could not replaced biopsy and hysteroscopy which would be the best method to diagnose endometrial cancer and avoid the prolongation of diagnosis or misdiagnosis.
出处
《中国误诊学杂志》
CAS
2004年第3期324-326,共3页
Chinese Journal of Misdiagnostics
基金
广州市科委资助
基金编号 :2 0 0 1 - Z- 0 4 3- 0 1 - 1 0
广东省卫生厅资助
基金编号 :A2 0 0 1 1 88
