The Clinical Value Of Endometrial Cytology In Monitoring Endometrial Lesions

Objective To explore the clinical value of endometrial cytological test(ECT)in monitoring endometrial carcinoma and precancerous lesions.Methods A total of 171 women with a suspect of endometrial disease from June,2017 to June,2018 in Anhui Provincial Hospital were enrolled in the study,cytology specimens by endometrial cytology was performed first,then diagnostic curettage was performed to obtain histological specimens.Compare the adequacy of specimens collected by the two methods,whether the postmenopause state and endometrial thickness affect the adequacy of specimens by these two methods,and the degree of pain,the amount of bleeding and the occurrence of uterine perforation were recorded in the two methods.The difference between ECT and diagnosis curettage was compared between pain,blood loss and uterine perforation.The sensitivity,specificity,positive predictive value,and negative predictive value of ECT in diagnosis of endometrial cancer and precancerous were calculate.Results(1)Twenty-three(13.45%)cytological specimens of 171 patients were unsatisfactory,and 18(10.53%)histological specimens were unsatisfactory,and the difference has no statistically significant(P>0.05).The satisfaction of the specimens in the diagnostic curettage group was affected by menopause and endometrial thickness,and the difference was statistically significant(P<0.05),but has no effect on the satisfaction of cytological specimens,and the difference has no statistically significant(P>0.05).(2)Patients in the ECT group were mainly mildly painful,while the patients in the diagnostic curettage group were mainly severely painful.The pain was statistically different between the two methods(P=0.000).The average amount of bleeding during the ECT examination was(1.04±0.39)ML,and(20.34±4.45)ML in diagnostic curettage group.The amount of bleeding was significantly higher than that of ECT.The difference was statistically significant(P=0.000);no one happened uterine perforation in patients undergoing ECT examination,but 8 patients occurred uterine perforation occurred in diagnostic curettage group.The incidence of uterine perforation was higher in curettage than that of ECT and the differences was statistically significant(P=0.004).(3)The sensitivity,specificity,positive predictive value and negative predictive value of ECT for diagnosis of endometrial cancer were 82.61%,98.31%,95.0%,and 96.67%,respectively.As for endometrial atypical hyperplasia were 78.57%,99.21%,91.67%,and 97.67%,respectively.Conclusions(1)There is no statistical difference of satisfaction of specimens between the diagnostic curettage of ECT.The ECT's specimens are not affected by the patient's menopause and endometrial thickness.(2)ECT examination is more convenient,the patient's pain is significantly reduced,and the incidence of bleeding and uterine perforation is also significantly lower than that of the diagnostic curettage;(3)The sensitivity,specificity,positive predictive value and negative predictive value of ECT for diagnosis of endometrial cancer and precancerous lesions are high,and the results are satisfactory.It has a certain value for clinical screening of endometrial diseases,especially for postmenopausal female.