CAJ | 학술논문

目的：评价分段诊刮在子宫内膜癌诊治中的价值。方法回顾性分析2006年1月至2012年12月南京中医药大学附属医院（江苏省中医院）妇科收治的82例子宫内膜癌患者的临床病理资料，以术后病理诊断为金标准，评价术前诊刮病理诊断子宫内膜癌的组织学分型、分级及宫颈浸润准确性。结果术前诊刮病理诊断子宫内膜癌组织学类型的符合率为87．80％，其中Ⅰ型子宫内膜癌的符合率为93．33％，Ⅱ型子宫内膜癌的符合率为50．00％。诊断肿瘤组织学分级符合率为73．33％，G1符合率80．00％，G2符合率72．22％，G3符合率100％。分段诊刮预测宫颈受累的灵敏度为54．55％，特异度91．55％，阳性预测值为50．00％，阴性预测值为92．86％。结论在子宫内膜癌（ FIGO）新分期标准下，分段诊刮仍然是子宫内膜癌术前病理分级及分期的有效方法，宫颈搔刮的阴性结果对判断宫颈受累情况更有意义，部分患者存在术后病理分级升高的情况。
목적：평개분단진괄재자궁내막암진치중적개치。방법회고성분석2006년1월지2012년12월남경중의약대학부속의원（강소성중의원）부과수치적82례자궁내막암환자적림상병리자료，이술후병리진단위금표준，평개술전진괄병리진단자궁내막암적조직학분형、분급급궁경침윤준학성。결과술전진괄병리진단자궁내막암조직학류형적부합솔위87．80％，기중Ⅰ형자궁내막암적부합솔위93．33％，Ⅱ형자궁내막암적부합솔위50．00％。진단종류조직학분급부합솔위73．33％，G1부합솔80．00％，G2부합솔72．22％，G3부합솔100％。분단진괄예측궁경수루적령민도위54．55％，특이도91．55％，양성예측치위50．00％，음성예측치위92．86％。결론재자궁내막암（ FIGO）신분기표준하，분단진괄잉연시자궁내막암술전병리분급급분기적유효방법，궁경소괄적음성결과대판단궁경수루정황경유의의，부분환자존재술후병리분급승고적정황。
Objective To assess the clinical significance of fractional curettage in diagnosis and treatment of endometrial cancer .Methods The clinical data of 82 cases with endometrial cancer hospitalized in Affiliated Hospital of Nanjing University of TCM from January 2006 to December 2012 were retrospectively analyzed .The hysterectomy pathology types were considered as golden standard .The accuracy of histologic classification , grading and cervical infiltration of the pathological diagnosis of endometrial carcinoma were analyzed .Results The overall coincidence rate of the histologic classification of endometrial cancer was 87.80% with preoperative fractional curettage (93.33%for typeⅠand 50.00%for type Ⅱ, respectively).The overall accuracy of the pathological diagnosis of histologic grading in preoperative fractional curettage was only 73.33%.The accuracy for G1, G2 and G3 was 80.00%, 72.22%and 100%, respectively .The sensitivity and specificity of fractional curettage in pathological diagnosis of cervical infiltration in endometrial cancer was 54.55% and 91.55%, respectively.The positive predictive value was 50.00%, and the negative predictive value was 92.86%.Conclusion Fractional curettage is still an acceptable diagnostic tool for preoperational evaluation of endometrial cancer with new FIGO staging system .Negative results of the cervical scratch scrape are more meaningful in judging the cervical infiltration .The postoperative pathological grading is upgraded in some patients.