摘要
目的探讨阴道镜下多点活检联合宫颈管搔刮诊断高度麟状上皮内病变(HSIL)的临床价值。方法选取2014年2月至2016年5月北京妇产医院经宫颈细胞学检测异常的患者106例,对患者进行阴道镜下多点活检联合宫颈管搔刮诊断,并进行宫颈环形电切术(LEEP)进行病理诊断,比较阴道镜下多点活检联合宫颈管搔刮诊断HSIL与病理诊断的符合率及漏诊率等。结果活检联合搔刮诊断出非宫颈上皮内瘤变(CIN)患者11例,低度鳞状上皮内病变(LSIL)患者31例,HSIL患者64例,LEEP术后病理诊断出非CIN17例,LSIL患者21例,HSIL患者68例,2种方法仅在轻度不典型增生(CINⅠ)诊断比较,差异有统计学意义(P<0.05)。以LEEP术后病理结果为金标准,阴道镜下多点活检联合宫颈管搔刮正确诊断HSIL 50例,灵敏度为80.88%,特异度为76.32%,阳性预测值为85.94%,漏诊率为19.12%,误诊率为23.67%,诊断符合率为79.25%。结论阴道镜下多点活检联合宫颈管搔刮对诊断HSIL患者具有较高的灵敏度、特异度及诊断符合率,但仍存在一定的漏诊与误诊,仍需要进一步行LEEP术病理诊断进行确诊,以降低宫颈癌的发生率。
Objective To investigate the colposcopic Biopsy plus endocervical curettage in diagnosis of squamous intraepithelial lesion height（HSIL）and the clinical value.Methods Selection from February 2014 to May 2016 in our hospital 106 cases of abnormal cervical cytological examination prompt patients as the research object,to all the selected patients with multi-point biopsy under colposcope joint cervical tube scratch the diagnosis,and the cervical loop cutting operation pathological diagnosis（LEEP）,compare the multi-point biopsy under colposcope joint HSIL cervical tube scratch scratch diagnosis and pathological diagnosis coincidence rate and missed diagnosis,etc.Results Biopsies＋ scratch scratch in CIN patients diagnosed in 11 cases,31 patients with LSIL,64 patients with HSIL,postoperative pathological diagnosis of LEEP CIN 17 cases,21 patients with LSIL,68 patients with HSIL,only two methods in the diagnosis of CINⅠ was significant differences（P〈0.05）;To LEEP postoperative pathologic results as the gold standard,multi-point biopsy under colposcope joint cervical tube scratch scratch HSIL 50 correct diagnosis example,the diagnostic sensitivity was 80.88%,76.32%,positive predictive value was 85.94%,19.12% missed diagnosis and misdiagnosis rate was 23.67%,the diagnostic coincidence rate was 79.25%.Conclusion Multi-point biopsy under colposcope joint cervical tube scratch scratch with high sensitivity in patients with diagnosis of HSIL,specific degrees and the diagnosis coincidence rate,but there are still some missed diagnosis and misdiagnosis.
出处
《检验医学与临床》
CAS
2017年第4期495-496,499,共3页
Laboratory Medicine and Clinic
关键词
阴道镜下多点活检
宫颈管搔刮
高度麟状上皮内病变
宫颈环形电切术
multiple biopsy under the vaginal
curettage of cervical canal
high-grade squamous intraepithelial lesion
loop electrical excision procedure
