关键词: 子宫内膜取样器, 诊断性刮宫, 宫腔镜, 组织学诊断, 可行性

Abstract: Objective To investigate the clinical feasibility of endometrial sampler in the diagnosis of endometrial lesions. Methods Prospective self-control method was applied to observe the reliability and feasibility of the endometrial sampler used in patients with endometrial biopsy indications, in compared with hysteroscopic endometrial biopsy subsequently. Endometrial tissue adequacy and histopathologic diagnoses were evaluated and compared between the two different sampling methods of endometrial biopsy in the same patient. The causes of biopsy failure and endometrial tissue inadequacy to make pathological diagnosis were also analyzed. Results The McNemar test for matched-pairs data about obtaining endometrial tissue shows the high consistency between the two groups(McNemar P=0.791).The coincidence rate of pathological diagnosis of endometrial tissue between the sampler and the curettage group was 92.56%. The overall diagnostic failure rates were 15.93%(29/182) and 14.28%(26/182)(χ²=0.193,P=0.770)for the sampler and the curettage group, respectively. The rates of none tissue obtained by the two methods were 13.18% (24/182)and 12.08%(22/182)(χ²=0.100,P=0.875),respectively. There was no significant difference in the quality of endometrial tissue obtained by the two sampling methods(χ²=0.188,P=0.910). Endometrial thickness was an independent risk factor for failure in the sampler group by multivariate analysis of high risk factors. The sampling failure rate in postmenopausal women in both groups was significantly higher than that in fertile women(both P<0.001). The failure rate in both curettage and sampler groups was 28.99% in postmenopausal patients. The failure rates of the two sampling methods were 1.77% and 3.54% for women of reproductive age,respectively. Conclusion Endometrial sampler was comparable to curettage in terms of tissue adequacy. The operation is simple, and patients have less pain. We definitively recommend the use of endometrial sampler in place of curettage for women of reproductive age and most menopause.

Key words: endometrial sampler, dilation and curettage, hysteroscopy, histological diagnosis, feasibility