摘要
目的：对比分析阴道镜下宫颈多点活检及宫颈管搔刮联合宫颈环形电切术（LEEP）在宫颈上皮内瘤变（CIN）中的诊断价值。方法：选取2010年1月~2013年12月在该科宫颈细胞学检测异常,进一步行阴道镜下宫颈多点活检＋宫颈管搔刮提示CIN的患者100例,反复宫颈细胞学检测异常及HPV持续阳性,但阴道镜下宫颈多点活检＋宫颈管搔刮阴性12例,共112例。行LEEP术后对比宫颈多点活检＋宫颈管搔刮和LEEP术后病理结果诊断的一致性。同时分析患者细胞学和HPV结果与宫颈CIN误诊的关系。结果：宫颈多点活检＋宫颈管搔刮同LEEP术最终病理诊断符合者71例（63.39%）,不符合者41例（36.61%）,其中诊断过度者18例（16.07%）,诊断不足者23例（23.54%）。两种检测方法在CIN-I的检测中存在统计学差异,P〈0.05。宫颈CIN的误诊和ASC-H及以上与HPV阳性显著相关,P〈0.05。结论：阴道镜下宫颈多点活检＋宫颈管搔刮诊断CIN可能存在一定的误诊及漏诊,进一步行LEEP术可通过提供完整组织标本弥补阴道镜检查的不足。
Objective： To compare and analyze the values of colposcopic cervical multi - point biopsy, endocervical curettage combined with cervical loop electrosurgical excision procedure （LEEP） in clinical diagnosis of cervical intraepithelial neoplasia （CIN） . Methods ： One hundred patients diagnosed as CIN by cervical cytological test, colposeopic cervical multi - point biopsy and endocervical curettage in the hospital from January 2010 to December 2013 were selected; 12 patients with abnormal cytological test result, persistent positive HPV and negative result of colposcopic cervical multi - point biopsy and endoeervieal curettage were selected during the same period. After LEEP, the coincidence rate of colposeopic cervical multi - point biopsy combined with endoeervical curettage and pathological examination was calculated. The relationship between cytological test, HPV detection result and cervical CIN misdiagnosis was analyzed. Results： The coinci- dence rate of eolposcopic cervical multi -point biopsy combined with endocervieal curettage and pathological examination was 63.39% （71 cases） , the misdiagnostie rate was 36. 61% （41 cases） , including overdiagnosis in 18 cases （ 16. 07% ） and underdiagnosis in 23 cases （ 23.54% ） . There was statistically significant difference in detection of CIN Ⅰ between the two detection methods （ P 〈 0. 05 ） . CIN misdiagnosis was positively correlated with ASC - H and above and positive HPV （ P 〈 0. 05 ） . Conclusion ： Colposeopic cervical multi - point biopsy combined with endocervical curettage has a certain probability of misdiagnosis and missed diagnosis in diagnosing C1N, further conducting LEEP can make up the disadvantages of eolposcopy by providing complete tissue specimens.
出处
《中国妇幼保健》
CAS
北大核心
2014年第33期5502-5504,共3页
Maternal and Child Health Care of China
基金
国家卫生与计划生育委员会项目〔2011-12号〕
关键词
阴道镜
宫颈多点活检
宫颈管搔刮
宫颈环形电切术
宫颈上皮内瘤变
Colposeope
Cervical multi -point biopsy
Endoeervical curettage
Cervical loop electrosurgical excision procedure
Cervical intraepithelial neoplasia
