【摘要】 目的:探讨术前血清CA125测定联合术中膜式液基薄层细胞学技术(TCT)检测腹水/腹腔冲洗液细胞学诊断对子宫内膜癌分期的影响。方法:回顾性分析2003年6月~2007年6月收治的子宫内膜癌86例,检测患者术前血清CA125同时应用新柏氏薄层细胞学检测系统术中进行腹水细胞学检测,就术前临床分期与手术-病理分期进行比较,分析其对子宫内膜癌分期的影响及两者间关系,并对结果进行统计学分析。结果:①子宫内膜癌腹水瘤细胞阴性组中血清CA125均值为(42.8±19.6)U/m l;腹水瘤细胞阳性组中血清CA125均值为(125.7±38.1)U/m l;腹水瘤细胞阳性组血清CA125水平高于腹水瘤细胞阴性组,差异有统计学意义(P<0.05)。②TCT涂片观察细胞形态清楚,因腹水瘤细胞阳性而使26例临床Ⅰ期中2例上调到手术-病理分期的Ⅲa期,由于腹腔细胞学检查所致的分期变更率7.7%,Ⅱ期变更率17.9%(5/28)。③TCT检测腹水细胞阳性率与肿瘤期别关系密切,Ⅲ、Ⅳ期中腹水/腹腔冲洗液瘤细胞阳性率为40.6%(13/32),与Ⅰ、Ⅱ期瘤细胞阳性率12.9%(7/54)比较,差异有统计学意义(P<0.05)。结论:腹水细胞学检查对子宫内膜癌分期的影响值得关注,术中收集腹水/腹腔冲洗液送检是子宫内膜癌重要的诊断程序,应用TCT检测能够提高子宫内膜癌腹水瘤细胞分布的集中程度,提高瘤细胞诊断率;联合术前血清CA125测定对于准确分期并指导术后临床治疗及评估预后,具有重要的临床意义。更多还原

【Abstract】 Objective:To study the effect of pre-operation orrho-CA125 and celiac cytology examination using Thinprep cytology test(TCT) on staging of endometrial carcinoma.Methods:86 cases of endometrial carcinoma treated in June 2003～June 2007 was carried out,Orrho-CA125 of pre-operation were detected in-operation with TCT.To compare pre-operation clinical staging with post-operation surgical-pathological staging(FIGO2000).To analyze the effect of ascites cytology examination on endometrial carcinoma staging and the relationship of them.The data was managed statistically.Results:①The general average orrho-CA125 of negative celiac cytology was(42.8±19.6)U/ml,the orrho-CA125 of positive celiac cytology was(125.7±38.1).There were significant difference between the two groups(P<0.05).②For the positive celiac cytology in TCT groups,2 of 26 cases of clinical stage I were adjusted to surgical-pathological Ⅲa stage with a staging discrepancy rate of 7.7%.The discrepancy rate in clinical Ⅱ was 17.9%(5/28).③The results were correlated with endometrial carcinoma staging,the positive celiac cytology of stages Ⅲand Ⅳ was 40.6%(13/32).Comparing with stage Ⅰ and Ⅱ(12.9%,7/54),there was significant difference between the two groups(P<0.05).Conclusion:The effect of celiac cytology examination on endometrial carcinoma staging has great diagnostic value.Before the exploratory laparotomy,the ascites and the celiac fluid should be collected for cytological examination.TCT can collect endometrial carcinoma ascites tumour cells,the smears quality are improved,the accuracy rate of malignant cell diagnosing is greatly increased.The clinic value of ascites cells examination and pre-operation Orrho-CA125 detection is significant for accurating staging,directing postop-iateria and prognosis assessment.更多还原