摘要
目的研究经阴道三维超声技术对子宫内膜癌肌层浸润的诊断价值。方法选择2019年5月至2020年1月南方医科大学附属普宁华侨医院超声科检查并经术后病理证实为子宫内膜癌患者63例作为研究对象。所有患者均给予二维超声与三维超声检查,记录患者的临床病理特征;对不同超声检查浸润情况的敏感度、阴性预测值进行比较;采用Logistic多元回归方程分析不同肿瘤体积与出现深肌层浸润的概率。结果患者年龄37~67岁,无、浅、深肌层浸润者分别为6例、36例、21例,高、中、低病理分化分别为33例、16例、14例,Ⅰ、Ⅱ、Ⅲ、Ⅳ手术病理分期分别为38例、13例、10例、2例;三维超声诊断对浅肌层浸润情况的敏感度、阴性预测值分别为93.3%、68.1%,明显高于二维超声诊断的45.6%、21.7%,差异均有统计学意义(P<0.05);二维超声与三维超声的多平面成像技术对深肌层浸润情况诊断的敏感度、阴性预测值分别为73.4%、87.6%和74.1%、89.1%,差异均无统计学意义(P>0.05);不同深度肌层浸润患者的肿瘤体积比较差异有统计学意义(P<0.05),而子宫体积比较差异无统计学意义(P>0.05);Logistic多元回归方程分析结果显示当肿瘤体积分别为48.79 cm^3、42.41 cm^3、37.62 cm^3、18.27 cm^3时,出现深肌层浸润的概率分别为92.0%、84.0%、81.0%、53.0%。结论三维超声在诊断子宫内膜癌肌层浸润深度方面有一定的价值,能够作为子宫内膜癌肌层浸润尤其是浅肌层浸润的诊断手段,值得临床推广运用。
Objective To study the diagnostic value of transvaginal three-dimensional ultrasound in myometrial invasion of endometrial carcinoma.Methods From May 2019 to January 2020,63 patients with endometrial carcinoma confirmed by pathology were selected as the research objects.All patients were given two-dimensional ultrasound and three-dimensional ultrasound examination,and the clinical and pathological characteristics of patients were recorded;the sensitivity and negative predictive value of different ultrasound infiltration were compared;the probability of different tumor volume and deep muscle invasion was analyzed by logistic multiple regression equation.Results The age of the patients ranged from 37 to 67 years.There were 6 cases without myometrial invasion,36 cases with shallow myometrial invasion,and 21 cases with deep myometrial invasion;33 cases,16 cases,and 14 cases with high,medium,and low pathological differentiation;38 cases,13 cases,10 cases;and 2 cases of pathological staging ofⅠ,Ⅱ,Ⅲ,andⅣ.The sensitivity and negative predictive value of three-dimensional ultrasound in the diagnosis of superficial muscle invasion were 93.3%and 68.1%,which were significantly higher than 45.6%and 21.7%of two-dimensional ultrasound diagnosis(P<0.05);the sensitivity and negative predictive value of two-dimensional ultrasound and three-dimensional ultrasound in the diagnosis of deep muscle invasion were 73.4%,87.6%,and 74.1%,89.1%,with no significant difference(P>0.05).There was significant difference in tumor volume among patients with different depth of myometrial invasion(P<0.05),but there was no significant difference in uterine volume(P>0.05).Logistic regression analysis showed that when the tumor volume was 48.79 cm^2,42.41 cm^2,37.62 cm^2,18.27cm3,and the probability of deep muscle invasion was 92.0%,84.0%,81.0%,53.0%.Conclusion Three dimensional ultrasound in the diagnosis of endometrial cancer myometrial invasion depth has a certain value,which can be used as a diagnostic means of endometrial cancer myometrial
作者
黄翠云
陈兰香
陈武镇
曾婷婷
HUANG Cui-yun;CHEN Lan-xiang;CHEN Wu-zhen;ZENG Ting-ting(Department of Ultrasound,Puning Overseas Chinese Hospital Affiliated to Southern Medical University,Puning 515300,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第24期3211-3214,共4页
Hainan Medical Journal
基金
广东省揭阳市卫生健康局医学科学研究项目(编号:揭市卫【2019】66号)。
关键词
子宫内膜癌
二维超声
三维超声
肌层浸润
诊断价值
Endometrial carcinoma
Two-dimensional ultrasound
Three-dimensional ultrasound
Myometrial invasion
Diagnostic value
