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目的研究阴道超声和宫腔镜在诊断子宫内膜癌上的临床价值,比较2者的差异,评价2者在子宫内膜癌诊断上的优势。方法以2008年4月至2012年8月2家医院收治的不规则子宫出血患者289例为对象,通过阴道超声和宫腔镜检查的结果,对比分析出各自在诊断子宫内膜癌中的不同点。结果 289例患者中共诊断162例子宫内膜癌,其中阴道超声准确诊断子宫内膜癌132例,准确率为80.97%;宫腔镜准确诊断子宫内膜癌150例,准确率为92.39%;宫腔镜诊断准确率优于阴道超声(P<0.05)。阴道超声诊断子宫内膜癌灵敏度为81.48%,特异度为80.31%,假阴性率为18.52%,假阳性率为19.69%,总的阳性和阴性预测值分别是84.08%和77.27%,约登指数为61.79%;宫腔镜诊断子宫内膜癌灵敏度为92.59%,特异度为92.13%,假阴性率为7.41%,假阳性率为7.87%,总的阳性和阴性预测值分别是93.75%和90.70%,约登指数为84.72%。结论经阴道超声和宫腔镜均可以诊断子宫内膜癌,但宫腔镜检查有更高的敏感性和准确性。
Objective To study the clinical value of vaginal ultrasonography and hysteroscopy in the diagnosis of endometrial cancer, and to compare the differences between the two and evaluate the advantages of both in the diagnosis of endometrial cancer. Methods A total of 289 patients with irregular uterine bleeding were treated in two hospitals from April 2008 to August 2012. The results of transvaginal sonography and hysteroscopy were compared to analyze their respective differences in the diagnosis of endometrial cancer point. Results A total of 162 cases of endometrial cancer were diagnosed in 289 cases. Among them, 132 cases of endometrial carcinoma were correctly diagnosed by vaginal ultrasound with an accuracy rate of 80.97%. Hysteroscopy accurately diagnosed 150 cases of endometrial carcinoma with an accuracy rate of 92.39% Endoscopic diagnostic accuracy is better than vaginal ultrasound (P <0.05). Vaginal ultrasound diagnosis of endometrial cancer sensitivity was 81.48%, specificity was 80.31%, false negative rate was 18.52%, false positive rate was 19.69%, the total positive and negative predictive values were 84.08% and 77.27%, respectively, Youden index Hysteroscopic diagnosis of endometrial cancer with sensitivity of 92.59%, specificity of 92.13%, false negative rate of 7.41%, false positive rate of 7.87%, the total positive and negative predictive values were 93.75% and 90.70 %, Youden index was 84.72%. Conclusion Transvaginal ultrasound and hysteroscopy can diagnose endometrial cancer, but hysteroscopy has higher sensitivity and accuracy.