摘要
目的本文通过分析高级妇科医师对疑诊子宫内膜增生(单纯性或复杂性)患者进行宫腔镜临床诊断与最后病理学诊断的一致性,从而评估宫腔镜诊断子宫内膜增生的准确性。方法这是一项前瞻性队列研究,时间从2019年1月—12月,入组标准为:绝经后出血;经超声诊断的子宫内膜增厚(绝经前或绝经后)。所有患者采用6 mm的宫腔镜,高级医师凭经验作出临床诊断,同时取子宫内膜做病理诊断。结果在142名患者中,高级医师对96名患者做出了子宫内膜增生(单纯性或复杂性)的临床诊断,其中57例得到病理结果证实(59.4%,P=0.0001);病理检查另外发现3例子宫内膜癌或不典型增生。子宫内膜增生的敏感性、特异性、阳性预测值和阴性预测值分别为90.6%、48.2%、58.1%和86.4%。对于术前有绝经后子宫内膜增厚的患者诊断子宫内膜增生的敏感性更高。结论高级妇科医师使用宫腔镜在子宫内膜增生的诊断中准确性较高。
Objective The purpose of this study was to evaluate the concordance between the clinical diagnosis of endometrial hyperplasia(EH)(simple or complex),suspected by senior gynecologists throughout hysteroscopy,and the results from pathological examination,in order to evaluate hysteroscopic accuracy for EH.Methods A prospective cohort study was done from January to December 2019,patients with the following criteria were recruited:endometrial thickening in pre-or post-menopause,and abnormal uterine bleeding in post-menopause.The patients were underwent hysteroscopy with a 6 mm hysteroscope.Senior physicians make clinical diagnosis based on experience.Pathological examination was conducted to confirm the diagnosis.Results In 142 participants,96 cases of EH were diagnosed by senior surgeons.A pathological diagnosis was confirmed in 57 cases(59.4%,P=0.0001).In further,three atypical hyperplasia and endometrial carcinoma were found.The sensitivity,specificity,positive predictive value,and negative predictive values for EH were 90.6%,48.2%,58.1%,and 86.4%,respectively.The sensitivity,subdivided by clinical indication,was even higher in women with post-menopause endometrial thickening.Conclusion The accuracy of hysteroscopy with senior operators,was high in the diagnosis and prediction of endometrial hyperplasia.
作者
杨蓓
王位
庄秋婵
王祥珍
YANG Bei;WANG Wei;ZHUANG Qiuchan;WANGXiangzhen(Department of Gynaecology,Nanshan Maternity and Child Healthcare Hospital of Shenzhen,Shenzhen Guangdong 518000,China)
出处
《中国继续医学教育》
2020年第35期145-149,共5页
China Continuing Medical Education
基金
广东省医学科学技术研究基金项目(A2016517)。
关键词
宫腔镜
绝经后
子宫内膜癌
子宫内膜增生
敏感性
特异性
阳性预测值
阴性预测值
hysteroscopy
postmenopause
endometrial cancer
endometrial hyperplasia
sensitivity
specificity
positive predictive value
negative predictive value
