摘要
１９８８～１９９０年我院在宫颈癌高发现场首次应用阴道镜检查患者４８５例，在可评价的３３０例中，阴道镜诊断与镜下活检的组织学比较，包括诊断相差Ⅰ级在内，符合率为９５．２％，而细胞学结果与组织学的符合率仅７１．２％。阴道镜下活检与３６例手术标本对照，诊断正确率达９７．２％，与颈管刮术结果的符合率为８９．２％。在７９例宫颈癌中阴道镜和细胞学两种诊断方法相比二者的差异虽无统计学意义（Ｐ＝０．９６９１），但阴道镜检出癌的敏感性优于细胞学（８８．５％比５４．４％）。结果表明，阴道镜检查是诊断宫颈癌和癌前病变的另一个可靠方法。阴道镜和细胞学合用，不仅提高宫颈癌的早期诊断率，并减少了各自的假阴性。阴道镜下多点活检加颈管刮术，无癌漏诊，可有效地代替诊断性锥切。我们认为肉眼与细胞学，阴道镜下多点活检加颈管刮术及组织病理学可作为宫颈癌普查中初筛和精检相结合的综合早诊方法。
Abstract Four hundred and fifty six women were examined by
colposcopy in a high incidence area ofcervical cancer from May 1988 to June 1990.In the 330
evaluable cases, colposcopic impression corre-lated accurately with the histologic
diagnosis(including difference of one degree )in 95.2% of the cases,while cytology in 71.2%
only. Directed biopsies under colposcopy were compared with surgical spec-imen of 36 patients
and the diagnostic accurate rate was 97.2%. The confirmation rate betweencolposcopy and
endocervical curettage was 89.2%.Among 79 Patients with cervical cancer,the results ob-tained
by colposcopy and cytology did not show a statistically significant difference
(P=0.9691).Howev-er,colposcopy was superior to cytology with regard to the sensitivity of
detection of early cervival cancer(88.5% vs 54.4%).When colposcopy was combined with
cytology,the diagnostic accurate rate of cervical cancer was further improved (94.9%).This study
demonstrated that colposcopy is another relia-ble method for the diagnosis of cervial cancer
and precancerous lesions.The combination of colposcopy with cytology may not only improve
the diagnostic accuracy, but also reduce their false negative rate. We would suggest
application of colposcopy plus endocervical curettage combined with histopathologial
examination as an effective approach to improve the quality of screening of cervical cancers.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
1994年第1期59-62,共4页
Chinese Journal of Oncology
