摘要
宫腔镜检查目前是对可疑患有子宫内膜癌女性的金标准检查手段。但子宫内膜肿瘤细胞有机会在宫腔镜检查过程中脱落,并随着液体流入腹腔而发生被动转移。因此,宫腔镜在子宫内膜癌患者中的应用仍存在争议。文章阐述了对可疑患有子宫内膜癌的女性,接受诊断性宫腔镜检查中肿瘤转移风险的认识,保证手术安全所需的条件,以及宫腔镜在早期子宫内膜癌患者保留生育能力中的应用。根据目前的数据,可得出如下结论:(1)宫腔镜检查用于诊断早期子宫内膜癌是安全有效的方法。(2)操作过程中必须严格控制膨宫压力,以减少子宫内膜肿瘤细胞在腹腔内被动转移的风险。(3)在早期子宫内膜癌患者中,宫腔镜手术联合药物治疗是保留生育能力最有效的治疗方法。
Although hysteroscopy is currently the un⁃disputed gold standard for the examination of the uterine cavity in women with suspected endometrial carcinoma,it remains controversial as a procedure due to the fact that endometrial carcinoma cells may shed during hysteroscopy and be passively transported with fluid flow into the peritoneal cavity.The study presents the review of current knowledge regarding the risk of neoplasm metastases in women who receive diagnostic hysteroscopy and the conditions that have to be met for the procedure to be safe and the application in young patients with early-stage endometrial carcinoma.Based on the current data analysis we conclude that:(1)Diagnostic hysteroscopy is a useful,efficient and safe method when performed in women with endometrial carcinoma,especially in its early stages.(2)The dis⁃tension media used for endoscopic procedures in the uterine cavity must be strictly controlled for relatively low pressures to prevent the increase in risk of intra⁃peritoneal spread endometrial carcinoma(.3)A com⁃bined approach consisting of hysteroscopic tumor re⁃section and oral progestins and/or levonorgestrel in⁃trauterine releasing system is the most effective fer⁃tility-sparing treatment for patients with early-stage endometrial carcinoma.
作者
史小雨
冯力民
SHI Xiao-yu;FENG Li-min(Department of Obstetrics and Gynecology,Beijing Tian-tan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2023年第11期1070-1072,1073,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家卫生健康委能力建设和继续教育中心课题(GWJJ2020100205)。
关键词
子宫内膜肿瘤
宫腔镜
腹腔内癌细胞转移
生育能力保护
endometrial neoplasm
hysteroscopy
in⁃traperitoneal spread
fertility-sparing treatment
