The Clinical Value Of Endometrial Cytology Test In Endometrial Cancer Screening

Objective:To compare the endometrial cytology examination in the satisfaction rate,convenience degree,diagnosis results and pain degree with diagnostic curettage,and to explore its diagnostic value and application prospect in endometrial cancer and precancerous lesions.Methods:Select 70 patients with endometrial lesions who were treated in Jiangxi Maternal and Child Health Hospital from July 2019 to January 2020 planned to take diagnostic curettage(including abnormal vaginal bleeding and B-ultrasound suggesting endometrium Thickening,abnormal echo,etc.),and record all the patient’s’ medical history,all patients take transvaginal ultrasound to assess the endometrial thickness before the operation;when the operation began,the sap-1 endometrial sampler was used to obtain cytology specimens,Then perform diagnostic curettage to obtain histological specimens,and record the depth of each patient’s uterine cavity.When the two operations were performed,the patients’ pain level was evaluated separately.After the operation,the two specimens were sent to the pathology department for reading,and the satisfaction of the two methods was compared.The diagnostic curettage histological result was used as the gold standard to evaluate the accuracy and sensitivity(SE),specificity(SP),positive predictive value(PPV),negative predictive value(NPV)of ECT in the diagnosis of endometrial cancer.Results:In the 70 patients,65 of ECT specimens were successfully sampled,and the satisfaction rate of the specimens was 92.9%;67 of diagnosis and curettage specimens were successful,and the satisfaction rate of the specimens was 95.7%.Comparing the two,χ2 = 0.530,P > 0.05,the difference was not statisticallysignificant;in cervical dilation rate,only 3 cases(4.82%)of ECT had cervical dilation,and 12 cases(19.35%)were diagnosed by curettage.Comparing the two,χ2= 6.14,P <0.05,the difference is statistically significant.2.The pain level of ECT is relatively low,mainly mild pain,while the diagnosis and curettage are mostly moderate to severe pain.Compared with the two,χ2 = 137.2,P <0.05,the difference is statistically significant.3.Taking the diagnosis and curettage pathology as the "gold standard",the diagnostic conformity of ECT is 91.94%,the sensitivity for the diagnosis of endometrial cancer and precancerous lesions is 91.67%,the specificity is 97.37%,and the positive predictive value is 95.65%,The negative predictive value is 94.87%.4.When the ECT is consistent with the diagnosis of the curettage,the average thickness of the endometrium is(9.30 ± 3.11)mm and(6.20 ± 1.72)mm,and the depth of the uterine cavity is(7.49 ± 0.66)cm and(8.40 ± 0.89)cm,respectively.Conclusion:1.ECT has the same high satisfaction rates of specimen as diagnostic and curettage,it is more convenient to obtain the material,and has the conditions as a routine screening method.2.The degree of pain the patient suffers from ECT during operation is significantly lower than that of the diagnosis and curettage,and the degree of conformity of the diagnosis is also consistent with the diagnosis and curettage,with high sensitivity,specificity,positive predictive value,negative predictive value,as a qualified screening method is worthy in clinical application.3.When the examinee’s endometrium is thin or the uterine cavity is too large,it may have an impact on the result,and it needs to be combined with further examination and judgment.