【摘 要】
：
目的：回顾性分析子宫内膜癌手术前后诊断符合率,探讨不同辅助诊断方法的临床应用价值。方法：收集我院经手术病理确诊的287例子宫内膜癌临床资料,行手术前后病理类型、组织学分级、宫颈有无受累、肌层浸润程度比较,计数资料采用X2检验进行统计分析.结果：1.诊断性刮宫诊断病理类型的总符合率为77.7％,子宫内膜腺癌符合率为92.7％.2.诊断性刮宫诊断病理组织学分级总符合率为62.4％,术后组织学分级升级2
【机 构】
：
Department of gynecological tumor,The Tumor Hospital of Shantou University Medical College,Guangdong
【出 处】
：
2012医学科学前沿暨第二届个体化治疗与抗肿瘤药物研究新趋向研讨会
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目的：回顾性分析子宫内膜癌手术前后诊断符合率,探讨不同辅助诊断方法的临床应用价值。方法：收集我院经手术病理确诊的287例子宫内膜癌临床资料,行手术前后病理类型、组织学分级、宫颈有无受累、肌层浸润程度比较,计数资料采用X2检验进行统计分析.结果：1.诊断性刮宫诊断病理类型的总符合率为77.7％,子宫内膜腺癌符合率为92.7％.2.诊断性刮宫诊断病理组织学分级总符合率为62.4％,术后组织学分级升级24.7％.G1级符合率51.7％,G2级符合率66.1％,G3级符合率58.1％.3.诊刮+宫颈涂片、诊刮+宫颈活检、分段诊刮三种方法的诊断完全符合率分别为31.8％、16.7％、56.9％,P=0.001.诊刮+宫颈涂片VS诊刮+宫颈活检,P=0.225；诊刮+宫颈涂片VS分段诊刮,P=0.005；诊刮+宫颈活检VS分段诊刮,P=0.002.4.分段诊刮与术中快速病理诊断符合率比较：①两种方法病理类型诊断符合率分别为80.4％、91.8％,P=0.000.②两种方法组织学分级诊断符合率分别为67.6％、89.3％,P=0.000.③两种方法宫颈诊断符合率分别为84.3％、97.5％,P=0.000.④两种方法诊断完全符合率分别为56.9％、80.1％,P=0.000.5.超声对肌层浸润诊断总符合率71.1％,无肌层浸润符合率80.8％,浅肌层浸润符合率66.3％,深肌层浸润符合率75.8％；术中快速病理诊断肌层浸润总符合率95.6％,浅肌层浸润符合率94.3％,无肌层浸润及深肌层浸润与术后病理全部一致；超声与术中快速病理诊断肌层浸润准确性的比较,P=0.000.结论：1.分段诊刮是术前明确子宫内膜癌诊断最有价值的病理诊断方法,可判断病理类型、组织学分级、宫颈有无累及,为选择术式提供依据.2.分段诊刮不能明确子宫内膜癌肌层浸润深度,采用超声判断肌层浸润深度可弥补这一缺陷.3.术中行快速冰冻病理检查能进一步提高子宫内膜癌病理类型、组织学分级、宫颈有无受累及肌层浸润深度诊断的准确性.
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