子宫内膜细胞学涂片筛查子宫内膜癌

目的探讨利用子宫内膜细胞采集器采集宫腔细胞进行细胞学涂片筛查子宫内膜癌的可行性及应用价值。方法以2005年9月至2006年2月在苏州市母子医疗保健中心进行妇女病普查以及同期妇科、计划生育科就诊妇女445例为筛查对象,采用宫腔刷直接取材进行子宫内膜细胞学涂片方法筛查子宫内膜癌,将重度非典型增生和可疑内膜癌作为阳性结果,分段诊刮后送病理检查确诊;分析阳性结果与患者年龄、孕产史、绝经与否、绝经后宫腔是否有出血等因素的关系。结果使用细胞采集器取材满意率为91.7%(408/445),筛查结果阳性率为1.5%(6/408),阳性结果中66.7%(4/6)经诊断性刮宫确诊为子宫内膜癌;妇女年龄50岁以上、绝经、绝经后宫腔出血、阴道排液与子宫内膜癌的发生存在一定联系。结论宫腔细胞学方法筛查子宫内膜癌具有操作方便、取材成功率高、病人痛苦小、准确性较高等优点,具有较好的应用前景。

Cytological method for detection of endometrial carcinomas

Objective To perform an exploration of the feasibility and practical value of cytological method in endometrial carcinoma screening, using uniform sampling device. Methods Participants were recruited consecutively from women who came to Suzhou Maternal and Child Health Center for gynecological check-ups between September 2005 and February 2006.Endometrial samples were obtained by endometrial brushes. Endometrial severe atypical hyperplasia and suspicious endometrial carcinoma cytologically diagnosed were considered positive, and these cases were further certified by dilatation and curettage. Relationships were explored between pathological characteristics and women's age, menstrual status, postmenopausal bleeding, etc. Results Success rate of cytological sampling was 91.7 % (408/445). 6 (1.5 %) out of 408 smears were cytologically diagnosed positive, of which 4 (66.7 %) were confirmed histologically. Factors such as women's age above 50 years, postmenopause especially with uterine bleeding, vaginal discharge had a statistical correlation with endometrial carcinoma. Conclusion The cytological method for collecting samples has the features of simplicity, relative painlessness, low fees as well as good accuracy, and thus may be considered as an ideal screening test for endometrial carcinoma.