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目的评价改良子宫内膜采集器联合阴道内镜检查诊断子宫内膜病变的临床应用价值。方法2015年5月至2015年10月对74例可疑宫腔病变患者应用改良子宫内膜采集器(改良采集器组)通过阴道内镜检查评估宫腔状态后采集子宫内膜组织送病理学检查,并与宫腔镜检查定位诊断性刮宫(诊刮组)结果进行比较。结果子宫内膜采集器及宫腔镜定位诊断性刮宫标本满意率均为94.59%(70/74)。74例患者中,改良采集器组确诊为子宫内膜恶性病变7例,其特异度为98.41%(62/63),灵敏度为63.64%(7/11),诊刮组确诊为子宫内膜恶性病变11例,两种方法的符合率为93.24%(69/74),Kappa值为0.699,ROC曲线下面积为0.810。结论使用改良子宫内膜采集器可在阴道内镜检查后直接进行内膜活检,并且可获取较满意标本。
Objective To evaluate the clinical value of modified endometrial harvester combined with vaginal endoscopy in the diagnosis of endometrial lesions. Methods From May 2015 to October 2015, 74 patients with suspected uterine lesions were treated with modified endometrial harvester (modified harvester) to assess the state of uterine cavity by vaginal endoscopy and then sent to the endometrium for pathological examination , And with hysteroscopy diagnostic curettage (curettage group) results were compared. Results The satisfaction rate of endometrial harvester and hysteroscopy in diagnosis of curettage specimens were 94.59% (70/74). Among the 74 patients, 7 cases were diagnosed as endometrial malignant lesions by modified harvester group, with a specificity of 98.41% (62/63) and a sensitivity of 63.64% (7/11). The curettage group was diagnosed as endometrial malignancy The lesions were found in 11 cases. The coincidence rate of the two methods was 93.24% (69/74), the Kappa value was 0.699 and the area under the ROC curve was 0.810. Conclusions The endometrial biopsy can be performed directly after vaginal endoscopy using a modified endometrial harvester, and more satisfactory specimens can be obtained.