对临床怀疑子宫内膜异位症的阴性腹膜活检的深层组织部位的诊断实用性
Constance V Chen1, Megan S Orlando2, Mary Kathryn Abel2
1Department of Pathology, University of California, San Francisco.
概括
更深入的组织切片分析提高了子宫内膜异位症诊断率6.7%,从初始采样中识别了虚假阴性. 这表明当初始子宫内膜异位症组织样本呈阴性时,更深的切口至关重要.
科学领域:
- 妇科病理学 妇科病理学
- 手术病理学手术病理学
- 生殖医学 生殖医学
背景情况:
- 确定的子宫内膜异位症诊断依赖于手术可视化病变的组织学确认.
- 当前组织学方法的诊断灵敏度有所不同,可能是由于组织采样不完整.
- 假阴性诊断可能会发生如果子宫内膜异位症的焦点在最初的组织部分很少.
研究的目的:
- 评估更深层组织部分在识别子宫内膜异位症的诊断价值.
- 为了确定更深层次的切割对整体诊断率的影响.
- 评估错过初始组织采样错过的错误阴性诊断的比率.
主要方法:
- 对135名因怀疑子宫内膜异位症而接受手术的患者进行了回顾性分析.
- 根据世卫组织的基本标准,对组织部分进行初始组织学检查.
- 样本的更深层次的切割在初步检查时呈阴性.
主要成果:
- 最初的切口诊断出73.3%的患者患有子宫内膜异位症 (99/135).
- 更深的切口导致额外的6.7%的诊断率,达到80% (108/135).
- 8.3%的患者在最初的组织截图上有错误的阴性诊断.
结论:
- 不完整的组织采样有助于假阴性子宫内膜异位症诊断.
- 更深层次的组织切割可以提高诊断产量和准确性.
- 考虑对负的初始样本进行更深的切割,以提高子宫内膜异位症检测率.
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