子宫内膜癌病理组织图与声像图的相关性分析

目的 探讨子宫内膜癌病理组织图与声像图的相关性.方法 对52例经病理证实为子宫内膜癌(内膜癌组)及86例经病理证实为子宫内膜增生过长(内膜增生组)两组共计138例患者的声像图表现及病理分型与分期表现进行分析.结果 (1)宫腔回声厚径内膜癌组患者宫腔回声厚径平均值为(19.9±9.8)mm,增生过长组宫腔回声厚径平均值为(11.9±5.7)mm,两组比较差异有非常显著性(P<0.01);(2)超声表现与病理相关性病理检出Ⅰ型子宫内膜癌46例,育龄期、围绝经期及绝经后检出率分别为28.26%(13/46)、39.13%(18/46)及32.61%(15/46);高分化腺癌宫腔回声厚径＞中低分化腺癌(P=0.05).52例内膜癌患者行子宫全切术46例,宫腔镜诊刮术1例,诊断性刮宫5例,其中41例全切子宫标本中见肌层癌浸润,Ⅱ期9例,Ⅲ期2例;肌层浸润深度与病变分化程度相关,与病理分期无明显的相关性;(3)漏诊3例中2例宫腔回声厚径小于10 mm,1例合并宫壁巨大病变;1例合并内膜息肉误诊.Ⅱ型子宫内膜癌6例,均为绝经后妇女.全切子宫5例,Ⅰ期3例,2例有肌层浸润;Ⅲ期2例,1例有肌层浸润.结论 子宫内膜癌组患者的宫腔回声平均厚径值明显大于增生过长组患者;超声检查提示病变的分期较判断肌层浸润更为重要.

Correlation Analysis between Clinical Pathological Findings and Sonographic Appearance of Endometrial Cancer

Objective To investigate pathological findings of endometrial cancer and their correlation with sonographic apperrance.Methods 183 cases (including 52 endometrial cancer patients and 86 patients with endometrial hyperplasia ) who underwent both ultrasonography and pathological examine were in this study.Preoperative sonography appearances were compared with the pathological findings.Results (1)The measurements of the uterine cavity thickness (mean 19.9±9.8 mm) by ultrasound in endometrial cancer group were greater than those (mean 11.9±5.7 mm) in endometrial hyperplasia group (P<0.01).(2) The correlation:46 cases were confirmed to have typeⅠendometrial cancer with pathological examine,among which there were child-bearing period women 28.26% (13/46) ,peri-menopausal 39.13 (18/46) and ,post-menopausal 32.61%.The measurements of the uterus cavity thickness in patients with well-differentiated endometrial cancer were greater than those with poor-differentiated endometrial cancer(P=0.05).Among 52 typeⅠendometrial cancer cases 46 cases underwent resected uterus,1 case underwent curettage use hysteroscopy,5 cases underwent diagnostic curettage of uterine.41 cases of 46 resected uterus cases showed myometrial invasion,9 cases in stage Ⅱ,2 cases in stage Ⅲ .There exists a certain correlation between the degree of myometrial invasion and the endometrial cancer.(3) Among the missed 3 cases,uterus cavity thickness＜10 mm in 2 cases and macrosis lesion of uterus wall was in 1 case.1 case was misdiagnosed accompanying endometrial polyp.6 post-menopausal patients with type Ⅱ endometrial cancer were all proved by histologically examination.The resected uteri in 5 patients showed 3 cases were in stageⅠ,among which two cases were with myometrial invasion and 2 cases were in stage Ⅲ in which 1 case was with myometrial invasion.Conclusions The average of uterine cavity thickness in patients with endometrial cancer were greater than that of the patients with endometrial hyperplasia by ultrasound.It is more important for us to pay attention to the stage of the endometrial cancer than to observe the degree of myometrial invasion in uterus by ultrasonography.