单纯经阴道超声与联合宫腔镜检查对子宫内膜癌诊断价值分析
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摘要
目的分析单纯经阴道超声与联合宫腔镜检查对子宫内膜癌诊断价值。方法选择2015年9月至2017年3月在湖北医药学院附属东风医院进行检查诊断的209例子宫出血患者,分别在明确诊断前行阴道超声和宫腔镜检查,并在宫腔镜直视下进行了病理活检或术后活检,其中84例确诊为子宫内膜癌。将单纯经阴道超声检查的结果作为对照组,联合宫腔镜检查的结果作为观察组,进行研究分析。按诊断方法分析阴道超声和电子宫腔镜在诊断子宫内膜癌上的灵敏度、特异性、阳性预测值、阴性预测值、假阴性率、假阳性率。结果 209例患者中确诊84例患者为子宫内膜癌,其中对照组诊断准确率为80. 95%,观察组诊断准确率为91. 67%。观察组诊断准确率优于对照组,差异具有统计学意义(P <0. 05)。对照组诊断子宫内膜癌灵敏度为93. 14%,特异性为80. 76%,阳性预测值为82. 76%,阴性预测值为77. 32%,假阴性率为6. 86%,假阳性率为19. 24%;观察组灵敏度为91. 02%,特异性为92. 26%,阳性预测值为93. 15%,阴性预测值为90. 83%,假阴性率为6. 98%,假阳性率为7. 74%。结论经阴道超声联合宫腔镜检查能够明显提高子宫内膜癌的诊断灵敏度和准确率。
Objective To analyze the diagnostic value of transvaginal ultrasonography combined with hysteroscopy in endometrial carcinoma. Methods 209 patients with uterine bleeding in our hospital from September 2015 to March 2017 received transvaginal ultrasonography and hysteroscopy,of which 84 cases were diagnosed as endometrial carcinoma. The results of transvaginal ultrasonography examination were chosen as control group,and the results of transvaginal ultrasonography combined with hysteroscopy were chosen as observation group. The sensitivity,specificity,positive predictive value,negative predictive value,false negative rate and false positive rate of the two groups in the diagnosis of endometrial carcinoma were analyzed. Results Of the 209 patients,84 patients were diagnosed as endometrial carcinoma. The accuracy of diagnosis in control group and observation group was 80. 95% and 91. 67% respectively,with statistically significant difference( P < 0. 05). In the aspect of the diagnosis of endometrial carcinoma,the sensitivity was 93. 14%,the specificity was 80. 76%,the positive predictive value was 82. 76%,the negative predictive value was 77. 32%,the false negative rate was 6. 86%,and the false positive rate was 19. 24% in the control group; in observation group,the sensitivity was 91. 02%,the specificity was92. 26%,the positive predictive value was 93. 15%,the negative predictive value was 90. 83%,the false negative rate was 6. 98%,and the false positive rate was 7. 74%. Conclusions Transvaginal ultrasonography combined with hysteroscopy can significantly improve the diagnostic sensitivity and accuracy of endometrial carcinoma.
Objective To analyze the diagnostic value of transvaginal ultrasonography combined with hysteroscopy in endometrial carcinoma. Methods 209 patients with uterine bleeding in our hospital from September 2015 to March 2017 received transvaginal ultrasonography and hysteroscopy,of which 84 cases were diagnosed as endometrial carcinoma. The results of transvaginal ultrasonography examination were chosen as control group,and the results of transvaginal ultrasonography combined with hysteroscopy were chosen as observation group. The sensitivity,specificity,positive predictive value,negative predictive value,false negative rate and false positive rate of the two groups in the diagnosis of endometrial carcinoma were analyzed. Results Of the 209 patients,84 patients were diagnosed as endometrial carcinoma. The accuracy of diagnosis in control group and observation group was 80. 95% and 91. 67% respectively,with statistically significant difference( P < 0. 05). In the aspect of the diagnosis of endometrial carcinoma,the sensitivity was 93. 14%,the specificity was 80. 76%,the positive predictive value was 82. 76%,the negative predictive value was 77. 32%,the false negative rate was 6. 86%,and the false positive rate was 19. 24% in the control group; in observation group,the sensitivity was 91. 02%,the specificity was92. 26%,the positive predictive value was 93. 15%,the negative predictive value was 90. 83%,the false negative rate was 6. 98%,and the false positive rate was 7. 74%. Conclusions Transvaginal ultrasonography combined with hysteroscopy can significantly improve the diagnostic sensitivity and accuracy of endometrial carcinoma.
引文
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[3]艾永航.宫腔镜在子宫内膜癌诊断中的应用价值[J].中华妇幼临床医学杂志(电子版),2015,11(1):69-71.
[4]赵祎琪,邓泽文,郄明蓉,等. 226例晚期子宫内膜癌的临床病理特征及治疗与其预后的相关因素分析[J].实用妇产科杂志,2017,33(7):506-511.
[5]程丹.经阴道彩色多普勒超声联合血浆肿瘤标志物在子宫内膜癌诊断中的应用[J].河南医学研究,2017,26(9):1666-1667.
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[8]张艳荣,赵志军,吴俊,等.四维超声在诊断子宫内膜癌中的应用[J].广东医学,2012,33(6):796-797.
[9]廖秦平,杨曦.子宫内膜癌筛查及早期诊断的现状及展望[J].实用妇产科杂志,2015,31(7):481-484.
[10]彭娟.经阴道超声改变与twist表达在早期子宫内膜癌诊断和转移中的应用价值[J].深圳中西医结合杂志,2016,26(8):65-67.
[11]刘颖蔚,黄琳娟,代雪林,等.磁共振扩散加权成像联合宫腔镜在子宫内膜癌诊断分期中的价值[J].现代医药卫生,2017,33(7):1052-1054.
[12] Nicoletta C,Carien C,Frederic A. ESMO-ESGO-ESTRO consensus conference on endometrial cancer:Diagnosis,treatment and follow-up[J]. Int J Gynecol Cancer,2016,26(1):2-30.
[13]李武,胡仙珍,刘松君,等.宫腔镜诊断早期子宫内膜癌的价值及安全性研究[J].中华腔镜外科杂志(电子版),2017,10(3):160-162.
[14]刘剑.子宫内膜癌的诊断与治疗体会[J].大家健康(上旬版),2017,11(5):192-193.
[15]赵冬梅.子宫内膜癌诊断中四维超声的应用剖析[J].医学信息,2015,28(47):379-380.
[16]董燕,柳建华.阴道彩色多普勒超声对子宫内膜息肉及子宫内膜癌的诊断价值[J].广州医科大学学报,2017,45(2):29-31.
[17] Gun Y,Chang WK,Nara Y,Stromal p16 expression is significantly increased in endometrial carcinoma[J]. Oncotarget. 2017,8(3):4826-4836.
[18]苏小锋,邸媛媛,李苗,等.宫腔镜对子宫内膜癌的诊断及癌细胞播散影响的研究[J].广东医科大学学报,2017,35(1):90-92.
[19]伦淑玲,马利亚,李丽娟,等.比较经阴道彩色多普勒与三维能量多普勒超声在早期子宫内膜癌诊断中的价值[J].中国实用医刊,2015,42(6):85-86.
[20]张志梅.宫腔镜联合B超检查在子宫内膜癌诊断中的价值[J].医学信息,2015,28(4):338-339.
[2]吴争勇,刘丽群. B型超声联合宫腔镜在子宫内膜癌诊断中临床价值[J].临床合理用药杂志,2017,10(22):155-156.
[3]艾永航.宫腔镜在子宫内膜癌诊断中的应用价值[J].中华妇幼临床医学杂志(电子版),2015,11(1):69-71.
[4]赵祎琪,邓泽文,郄明蓉,等. 226例晚期子宫内膜癌的临床病理特征及治疗与其预后的相关因素分析[J].实用妇产科杂志,2017,33(7):506-511.
[5]程丹.经阴道彩色多普勒超声联合血浆肿瘤标志物在子宫内膜癌诊断中的应用[J].河南医学研究,2017,26(9):1666-1667.
[6]罗业琳,雷嘉,黄卓华,等.子宫内膜癌预后因素的Cox回归分析[J].现代肿瘤医学,2015,23(14):2050-2053.
[7]段华,孙馥箐.宫腔镜在早期子宫内膜癌诊断中的应用[J].中国医师杂志,2015,17(8):1135-1139.
[8]张艳荣,赵志军,吴俊,等.四维超声在诊断子宫内膜癌中的应用[J].广东医学,2012,33(6):796-797.
[9]廖秦平,杨曦.子宫内膜癌筛查及早期诊断的现状及展望[J].实用妇产科杂志,2015,31(7):481-484.
[10]彭娟.经阴道超声改变与twist表达在早期子宫内膜癌诊断和转移中的应用价值[J].深圳中西医结合杂志,2016,26(8):65-67.
[11]刘颖蔚,黄琳娟,代雪林,等.磁共振扩散加权成像联合宫腔镜在子宫内膜癌诊断分期中的价值[J].现代医药卫生,2017,33(7):1052-1054.
[12] Nicoletta C,Carien C,Frederic A. ESMO-ESGO-ESTRO consensus conference on endometrial cancer:Diagnosis,treatment and follow-up[J]. Int J Gynecol Cancer,2016,26(1):2-30.
[13]李武,胡仙珍,刘松君,等.宫腔镜诊断早期子宫内膜癌的价值及安全性研究[J].中华腔镜外科杂志(电子版),2017,10(3):160-162.
[14]刘剑.子宫内膜癌的诊断与治疗体会[J].大家健康(上旬版),2017,11(5):192-193.
[15]赵冬梅.子宫内膜癌诊断中四维超声的应用剖析[J].医学信息,2015,28(47):379-380.
[16]董燕,柳建华.阴道彩色多普勒超声对子宫内膜息肉及子宫内膜癌的诊断价值[J].广州医科大学学报,2017,45(2):29-31.
[17] Gun Y,Chang WK,Nara Y,Stromal p16 expression is significantly increased in endometrial carcinoma[J]. Oncotarget. 2017,8(3):4826-4836.
[18]苏小锋,邸媛媛,李苗,等.宫腔镜对子宫内膜癌的诊断及癌细胞播散影响的研究[J].广东医科大学学报,2017,35(1):90-92.
[19]伦淑玲,马利亚,李丽娟,等.比较经阴道彩色多普勒与三维能量多普勒超声在早期子宫内膜癌诊断中的价值[J].中国实用医刊,2015,42(6):85-86.
[20]张志梅.宫腔镜联合B超检查在子宫内膜癌诊断中的价值[J].医学信息,2015,28(4):338-339.