CAJ | 학술논문

目的：探讨影响分段诊断性刮宫术（诊刮）诊断子宫内膜癌准确率的临床病理因素。方法回顾性分析128例子宫内膜癌患者的临床资料，分析分段诊刮诊断与术后病理诊断的符合率，并分析98例子宫内膜样腺癌分级与术后病理诊断的符合率。结果术前分段诊刮对128例子宫内膜癌患者诊断结果与术后切除标本病理结果有相关（χ2=424.958，p=0.000），且一致性良好（ Kappa指数=0.871）。术前分段诊刮对98例子宫内膜样腺癌分级与术后切除标本病理结果有相关（χ2=52.648，p=0.000），但一致性差（ Kappa指数=0.348）。结论分段诊刮对于子宫内膜癌病理分型的诊断有临床意义；术前分段诊刮诊断子宫内膜癌的病理分级有一定的局限性，临床上对分段诊刮得出的肿瘤病理级别结果应谨慎，以防治疗过度和治疗不足。
목적：탐토영향분단진단성괄궁술（진괄）진단자궁내막암준학솔적림상병리인소。방법회고성분석128례자궁내막암환자적림상자료，분석분단진괄진단여술후병리진단적부합솔，병분석98례자궁내막양선암분급여술후병리진단적부합솔。결과술전분단진괄대128례자궁내막암환자진단결과여술후절제표본병리결과유상관（χ2=424.958，p=0.000），차일치성량호（ Kappa지수=0.871）。술전분단진괄대98례자궁내막양선암분급여술후절제표본병리결과유상관（χ2=52.648，p=0.000），단일치성차（ Kappa지수=0.348）。결론분단진괄대우자궁내막암병리분형적진단유림상의의；술전분단진괄진단자궁내막암적병리분급유일정적국한성，림상상대분단진괄득출적종류병리급별결과응근신，이방치료과도화치료불족。
OcjectiVe To investigate the clinical pathological factors influencing the accuracy of the diagnosis of tumors by dilatation and curettage. Methods Clinicopathological data of 128 patients with endometrial carcinoma were collected to analyze the pathological diagnostic concordance rate between postoperative permanent section and preoperative dilatation and curettage. The accuracies of the endometrioid adenocarcinoma grades of 98 cases were also compared between the preoperative dilatation and curettage and postoperative pathological findings. Results The preoperative dilatation and curettage in 128 patients with endometrial cancer diagnosis and postoperative permanent section results were related (χ2 = 424 . 958 ,p =0 . 000 ),and the consistency of two results was good( Kappa value 0 . 871 ). The preoperative dilatation and curettage in 98 cases of endometrioid adenocarcinoma classification and postoperative biopsy results were related(χ2 =52 . 648 ,p=0 . 000 ),but the consistency of two results was poor( Kappa value 0 . 348 ). Conclusion The dilation and curettage had some clinical significance in diagnosing pathological analysis of endometrial carcinoma,but it had certain limitations. There was a relatively poor correlation in the diagnosis of endometrial carcinoma between preoperative grade on dilation and curettage and final pathologic analysis. Therefore,the information of tumor grade obtained from the dilation and curettage should be cautiously balanced to prevent its over-treatment or under-treatment.