经阴道三维超声联合血人绒毛膜促性腺激素对子宫内膜癌的诊断价值(1)
[摘要]目的 探討经阴道三维超声联合血人绒毛膜促性腺激素对子宫内膜癌的诊断价值。方法 收集我院及南海区第四人民医院2015年8月～2016年10月的90例绝经2年以上阴道流血患者，按照病理检查结果分为子宫内膜增生组(n=64)与子宫内膜癌组(n=26)。两组均经阴道三维超声检查后测量内膜厚度及容积，采用化学发光法(CLIA)测定血清人绒毛膜促性腺激素(β-HCG)水平，比较两组的子宫内膜厚度、容积及血清β-HCG水平，并比较血β-HCG法、三维超声法及三维超声法联合血β-HCG法对良、恶性病变的正确诊断率、漏诊率、误诊率及灵敏度、特异度、阳性预测值、阴性预测值、准确度。结果 子宫内膜癌组的内膜厚度、内膜体积显著大于子宫内膜增生组，血β-HCG水平显著高于子宫内膜增生组，差异有统计学意义(P<0.05)。三维超声联合血β-HGC法具有较高的正确诊断率，误诊、漏诊率较低。与三维超声联合血HCG法相比，血HCG法与三维超声法的灵敏度、特异度、阳性预测值、阴性预测值、准确度均较低，差异有统计学意义(P<0.05)。结论 经阴道三维超声联合血β-HGC可提高对子宫内膜癌早期诊断的确诊率，具有较高的灵敏度、特异度，能够为临床医生的早诊断、早处理提供依据，可以让更多的患者得到早期治疗，极大地改善了患者预后，具有重大意义。
[关键词]经阴道三维超声；血HCG；子宫内膜癌；诊断
[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-4721(2017)04(c)-0103-04
[Abstract]Objective To investigate the diagnostic value of transvaginal three-dimensional ultrasonography combining with human chorionic gonadotropin (HCG) in patients with endometrial carcinoma.Methods From August 2015 to October 2016，90 patients with vaginal bleeding for more than two years after postmenopausal period were collected in our hospital and the Fourth People′s Hospital of Nanhai District and divided into the endometrial hyperplasia group (n=64) and the endometrial carcinoma group (n=26) according to histopathological examinations.The endometrial thickness and volume were measured by transvaginal three-dimensional ultrasonography in both groups.The level of serum β-HCG was determined by chemilumineseent immunoassay (CLIA).The endometrial thickness and volume as well as serum β-HCG level were compared in the two groups.Besides，correct diagnostic rate，the rate of missed diagnosis，misdiagnosis rate，sensitivity，specificity，positive predictive value，negative predictive value，and accuracy on benign and malignant diseases of serum HCG，three-dimensional ultrasonography and three-dimensional ultrasonography combining with serum HCG were compared.Results In the endometrial carcinoma group，endometrial thickness，volume was larger than that in the endometrial hyperplasia group，and serum β-HGC level was higher than that in the endometrial hyperplasia group，with significant difference (P<0.05).The correct diagnostic rate was higher and the misdiagnosis rate and rate of missed diagnosis were both lower by three-dimensional ultrasonography combining with serum HCG.In comparison with three-dimensional ultrasonography combining with serum HCG，sensitivity，specificity，positive predictive value，negative predictive value，and accuracy by serum HCG or three-dimensional ultrasonography only were all lower，which was displayed statistical difference (P<0.05).Conclusion Transvaginal three-dimensional ultrasonography combining with serum HCG can improve the diagnosis rate of early-stage of endometrial carcinoma with higher sensitivity and specificity，which provides the basis for early diagnosis and treatment by physicians，so that more patients will get early treatment.It greatly improve patients′ prognosis and is of great significance. (郑小红 陈逢春 朱丽敏 罗丽芳 邓劲瑶 朱艳芳 全晓广)
[关键词]经阴道三维超声；血HCG；子宫内膜癌；诊断
[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-4721(2017)04(c)-0103-04
[Abstract]Objective To investigate the diagnostic value of transvaginal three-dimensional ultrasonography combining with human chorionic gonadotropin (HCG) in patients with endometrial carcinoma.Methods From August 2015 to October 2016，90 patients with vaginal bleeding for more than two years after postmenopausal period were collected in our hospital and the Fourth People′s Hospital of Nanhai District and divided into the endometrial hyperplasia group (n=64) and the endometrial carcinoma group (n=26) according to histopathological examinations.The endometrial thickness and volume were measured by transvaginal three-dimensional ultrasonography in both groups.The level of serum β-HCG was determined by chemilumineseent immunoassay (CLIA).The endometrial thickness and volume as well as serum β-HCG level were compared in the two groups.Besides，correct diagnostic rate，the rate of missed diagnosis，misdiagnosis rate，sensitivity，specificity，positive predictive value，negative predictive value，and accuracy on benign and malignant diseases of serum HCG，three-dimensional ultrasonography and three-dimensional ultrasonography combining with serum HCG were compared.Results In the endometrial carcinoma group，endometrial thickness，volume was larger than that in the endometrial hyperplasia group，and serum β-HGC level was higher than that in the endometrial hyperplasia group，with significant difference (P<0.05).The correct diagnostic rate was higher and the misdiagnosis rate and rate of missed diagnosis were both lower by three-dimensional ultrasonography combining with serum HCG.In comparison with three-dimensional ultrasonography combining with serum HCG，sensitivity，specificity，positive predictive value，negative predictive value，and accuracy by serum HCG or three-dimensional ultrasonography only were all lower，which was displayed statistical difference (P<0.05).Conclusion Transvaginal three-dimensional ultrasonography combining with serum HCG can improve the diagnosis rate of early-stage of endometrial carcinoma with higher sensitivity and specificity，which provides the basis for early diagnosis and treatment by physicians，so that more patients will get early treatment.It greatly improve patients′ prognosis and is of great significance. (郑小红 陈逢春 朱丽敏 罗丽芳 邓劲瑶 朱艳芳 全晓广)