摘要
【目的】探讨阴道镜下活检用于诊断宫颈鳞状上皮内病变的价值。【方法】对249例宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的患者行阴道镜下活检和宫颈锥切术,以病理结果作为诊断的金标准,评估阴道镜下活检诊断CIN的准确性,分析术后病理级别增加的相关因素。【结果】249例患者宫颈锥切术确诊炎症8例,CINⅠ45例,CINⅡ60例,CINⅢ134例,浸润癌2例。阴道镜下活检诊断CIN的总符合率为61.8%。阴道镜下活检对诊断高级别病变的灵敏度为96.94%,特异度为75.47%,阳性预测值为82.61%,阴性预测值为68.42%。阴道镜检查不充分、阴道镜下宫颈病变累积多个象限、活检时有多个高级别病变与术后病理级别增加相关(P<0.05)。【结论】阴道镜在识别CIN中有重要的价值,但由于阴道镜下取材的局限性,阴道镜下活检病理确诊CIN尚不够准确。因此,对于一些高级别病变的患者需要进行宫颈锥切明确诊断。
【Objective】To explore the value of colposcopy biopsy in the diagnosis for cervical squamous intraepithelial lesions.【Methods】A total of 249 patients with cervical intraepithelial neoplasia（CIN） were treated with colposcopic biopsy and cervical conization.The results of pathological examination was considered as the diagnostical golden standard.The accuracy of colposcopy biopsy was evaluated in diagnosing CIN.The related factors of increased postoperative pathological grade were analyzed.【Results】The results of cervical conization indicated that there were 8 cases with inflammation,45 cases with CINⅠ,60 cases with CINⅡ,134 cases with CINⅢ and 2 cases with invasive carcinoma of cervix uteri in all 249 patients.The total coincidence rate of colposcopy biopsy in the diagnosis for CIN was 61.8%.The sensitivity,specificity,positive predictive value and negative predictive value of colposcopic biopsy in the diagnosis for high-grade lesions were 96.94%,75.47%,82.61% and 68.42%.Insufficient colposcopy,cervical lesions in multiple quadrants under colposcopy and multiple high-grade lesions under biopsy were related to the increased postoperative pathological grade（P〈0.05）.【Conclusion】Colposcopy is of significant value in the diagnosis for CIN.However,colposcopic biopsy in the diagnosis for CIN is still not accurate enough due to the limitations of specimen collection.Thus,some patients with high-grade lesions need the confirmation of cervical conization.
出处
《武警后勤学院学报（医学版）》
CAS
2017年第3期212-215,共4页
Journal of Logistics University of PAP（Medical Sciences）
关键词
阴道镜
宫颈上皮内瘤变
宫颈锥切术
Colposcope
Cervical intraepithelial neoplasia
Cervical conization
