经阴道超声测量对绝经后子宫内膜癌的诊断价值

目的：评价经阴道超声测量对绝经后子宫内膜癌的诊断价值。方法：选择因经阴道超声提示宫腔占位行宫腔镜检查术绝经后妇女520例,分析绝经后子宫内膜癌患者的相关特征。以病理诊断结果为金标准,评价经阴道超声和宫腔镜诊断子宫内膜癌的灵敏度和特异度。以ROC曲线下面积确定经阴道超声测量宫腔占位大小诊断绝经后子宫内膜癌的最佳临界值。结果：绝经后阴道流血（postmenopausal bleeding,PMB）、宫腔占位大及宫腔积液多与绝经后子宫内膜癌相关,而年龄、绝经年龄、绝经时间、内膜厚度与绝经后子宫内膜癌无关。伴PMB妇女的子宫内膜癌发生率是无PMB妇女的6.4倍。宫腔镜诊断绝经后子宫内膜癌的准确性高于经...

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Bibliographic Details
Published in中国临床医学 Vol. 23; no. 6; pp. 768 - 772
Main Author 姚莉 谢锋
Format Journal Article
LanguageChinese
Published 复旦大学附属妇产科医院宫颈疾病诊疗中心，上海市女性生殖内分泌相关疾病重点实验室，上海 200011 2016
Subjects
子宫内膜癌
宫腔占位
经阴道超声
绝经后
polypoid mass in uterine cavity
经阴道超声
子宫内膜癌
绝经后
endometrial cancer
transvaginal ultrasonography
宫腔占位
postmenopausal
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ISSN1008-6358
DOI10.12025/j.issn.1008-6358.2016.20160711

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Summary:目的：评价经阴道超声测量对绝经后子宫内膜癌的诊断价值。方法：选择因经阴道超声提示宫腔占位行宫腔镜检查术绝经后妇女520例,分析绝经后子宫内膜癌患者的相关特征。以病理诊断结果为金标准,评价经阴道超声和宫腔镜诊断子宫内膜癌的灵敏度和特异度。以ROC曲线下面积确定经阴道超声测量宫腔占位大小诊断绝经后子宫内膜癌的最佳临界值。结果：绝经后阴道流血（postmenopausal bleeding,PMB）、宫腔占位大及宫腔积液多与绝经后子宫内膜癌相关,而年龄、绝经年龄、绝经时间、内膜厚度与绝经后子宫内膜癌无关。伴PMB妇女的子宫内膜癌发生率是无PMB妇女的6.4倍。宫腔镜诊断绝经后子宫内膜癌的准确性高于经阴道超声。超声测量宫腔占位大小诊断无PMB子宫内膜癌的最佳临界值为14.5mm,此时阳性预测值为10.75%、阴性预测值为99.14%。超声测量宫腔占位大小诊断伴PMB绝经后子宫内膜癌的最佳临界值为18.5mm,此时阳性预测值为55.56%、阴性预测值为91.94%。结论：对于无PMB的妇女,经阴道超声测量宫腔占位大于14.5mm作为行宫腔镜检查的指征较合理;而对于经阴道超声发现宫腔占位且伴PMB的妇女,子宫内膜癌发生率较高,建议均行宫腔镜检查。
Bibliography:Y A O L i, X IE Feng（The Medical Center of Diagnosis and T reat for Cervical Diseases, the Obstetrics and Gynecology Hospital of Fudan University,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases Shanghai 200011, China）
31-1794/R
transvaginal ultrasonography; polypoid mass in uterine cavity; endometrial cancer; postmenopausal
Objective ： T o evaluate the value of transvaginal ultrasonographic （T V S ） measurement of polypoid mass inuterine cavity in identifying postmenopausal endometrial cancer. Methods： Totally 520 postmenopausal women acceptedhysteroscopy（H y） for polypoid mass in uterine cavity by T V S . Characteristics of postmenopausal women with endometrialcancer were analyzed. T h e sensitivity and specificity of T V S and Hy diagnosing endometrial cancer were calculated with thehistological results being the gold standard. T h e best cut-off point of the size of polypoid mass by T V S diagnosing endometrialcancer was determined by RO C curve. T h e positive predictive value （P P
ISSN:1008-6358
DOI:10.12025/j.issn.1008-6358.2016.20160711