| Objective:Endometrial carcinoma is one of the malignant tumors of the female genital tract.In recent years, the incidence is rising more and more and the onset age is become younger. Patients with early diagnosis and timely treatment can improve the postoperative survival rate.Transvaginal ultrasound examination can not only by measuring the endometrial thickness and observing the characteristics of endometrial echo to make an early diagnosis of endometrial cancer, but also by measuring the myometrial invasion of endometrial and observing whether the cervical stromal invased to predict the stage of endometrial cancer. Studying on the value of transvaginal ultrasonogrphy in endometrial cancer diagnosis and staging has an important significance in the early diagnosis of endometrial carcinoma and the preoperative staging of endometrial carcinoma, formulating treatment plans, improving prognosis and patients quality of life.The aim of this study is to use evidence-based medicine core research method. On preoperative vaginal ultrasound examination of patients with endometrial cancer clinical and pathological data were analysed, to evaluate the value of transvaginal ultrasound in the diagnosis and staging of endometrial cancer, in order to contribute to early diagnosis and preoperative staging of endometrial cancer, treatment plan formulation, condition evaluation and prognosis evaluation.Methods:Computer retrieval from 1990 to 2015 published at home and abroad about the vaginal ultrasound examination in the diagnosis and staging of endometrial carcinoma in the value of literature in English and Chinese,according to the inclusion criteria and exclusion criteria set by the filtered the retrieved literature, selected into the standard literature research.According to the scheme of screening, directly or indirectly extract into the literature of transvaginal ultrasonography in diagnosis of endometrial carcinoma, the diagnosis of endometrial carcinoma shallow muscular infiltration and the diagnosis of cervical carcinoma of endometrium stroma infiltration on the number of true positive(TP), the number of false positives(FP) and false negative number(FN), true negative number(TN).And on the basis of QUADAS quality evaluation criterion for end into the quality of literature evaluation, with Meta- disc1.4 software to calculate the sensitivity, the specificity, positive likelihood ratio and negative likelihood ratio, SROC curve drawing, and calculate the area under the curve(AUC),to evaluate the accuracy of transvaginal ultrasound examination for endometrial cancer diagnosis and predicting the stage.Results:According to the inclusion criteria and exclusion criteria, a total of 35 articles are accepted, including 12 references in Chinese and 23 references in English. There are 10 references(8 articles in English and 2 Chinese) about transvaginal ultrasonography to measure endometrial thickness in diagnosis of endometrial cancer, a total of 3293 cases of the object of study. The other 25 articles(English article 15, 10 Chinese) are all about transvaginal ultrasound in the diagnosis of endometrial carcinoma muscular infiltration value, a total of 2270 cases of the object of study. There are 7 articles(5 English article, 2 Chinese article) 825 subjects are contained also involving the value of transvaginal ultrasonography in the diagnosis of cervical stromal invasion of endometrium carcinoma. The value of transvaginal ultrasonography in the diagnosis of endometrial carcinoma by measuring the thickness of endometrial, when the thickness of endometrial ≥5mm, the diagnosis of endometrial cancinoma with the combined sensitivity is 0.84[95%CI(0.73,0.92)] and the combined specificity is 0.80[95%CI(0.76,0.84)]. Transvaginal ultrasonography in the diagnosis of myometrial invasion of endometrial carcinoma the combined sensitivity is 0.81[95%CI(0.79,-0.83)], the combined specificity is 0.79[95%CI(0.76,0.82)], the combined positive likelihood ratio is 4.06[95%CI(3.18,5.19)], the combined negative likelihood ratio is0.25[95%CI(0.21,0.30)], the combined diagnostic odds ratio is 18.73[95%CI( 12.86, 27.27)], the area under the curve(AUC) of SROC is0.8811. Transvaginal ultrasoundin the diagnosis of invasive cervical of endometrium carcinoma the combined sensitivity is 0.62[95%CI(0.52,0.72)], the combined specificity is 0.97[95%CI(0.95,0.98)], the combined positive likelihood ratio is 17.29[95%CI(6.96,42.95)], the combined negative likelihood ratio is 0.35[95%CI(0.21,0.60)], the combined diagnostic odds ratio is 67.83[95%CI( 16.68,275.73)], the area under curve(AUC) of SROC is 0.9572.Conclusion:1,Transvaginal ultrasonography with endometrial thickness exceeding 5 mm is better for early endometrial cancer screening.2,Transvaginal ultrasound in the diagnosis of myometrial invasion of endometrial carcinoma has a high sensitivity and specificity, the accuracy of TVS in vedict the myometrial invasion of endometrial carcinoma is high.3,Transvaginal ultrasound in the diagnosis of cervical stromal invasion of endometrial carcinoma has a low sensitivity and a high specificity,the accuracy of TVS in vedict the endometrial carcinoma without cervical stromal invasion is high, the accuracy of TVS in vedict the endometrial carcinoma with cervical stromal invasion is low. |
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