摘要
目的:通过回顾分析阴道镜引导下活检诊断宫颈高级别鳞状上皮内病变(HSIL)患者的活检位置,寻找宫颈最易发生病变的位置,探讨肉眼引导下宫颈随机取材检查的循证方法。方法:回顾分析复旦大学附属妇产科医院2015年1月1日至2015年12月31日阴道镜引导下宫颈点活检诊断HSIL者活检的位置和个数。结果:阴道镜引导下点活检诊断宫颈HSIL 1096例,共活检3563个点,平均3.25点/例。按每个位置点活检比例从高到低排列,依次为12点(16.0%)、6点(15.5%)、1点(10.2%)、7点(10.0%)、11点(9.6%)、5点(9.0%)、9点(8.6%)、3点(8.1%)、10点(4.0%)、4点(3.2%)、8点(3.0%)、2点(2.8%)。点活检数选择方面,按比例从高到低排列,依次为四点活检(42.2%)、三点活检(30.5%)、两点活检(19.7%)、五点活检(3.7%)、单点活检(3.3%)、六点活检(0.5%)。单点活检、两点活检、三点活检和四点活检中,最常见的两个活检位置均为12点和6点。结论:12点、6点、1点、7点可能是最易首先发生宫颈病变的位置。在无阴道镜的条件下,选择这四个点位检查可能对提高宫颈病变的检出率和正确性具有重要意义。
Objective：In the absence of colposcopy,random punch biopsy were usually taken at cervical 3°,6°,9° and 12° in conditions of abnormal cytology.However,no data show that the four locations above are most susceptible to cervical lesions up to now.Hence random biopsy method need more study.The aim of this study was to investigate colposcopy-directed punch biopsy locations of cervical high-grade squamous intraepithelial lesions（HSIL） in order to find out the most susceptible locations of cervical lesions.Methods：The locations and numbers of all cases of HSILs diagnosed by colposcopy-directed biopsy were retrospectively analyzed in Obstetrics and Gynecology Hospital of Fudan University between January 1,2015 and December 31,2015.Results：A total of 3563 points from 1096 cases of cervical HSIL diagnosed by colposcopy-directed biopsy were analyzed（3.25 points/cases on average）.Rankings（rates） of punch biopsy locations were 12°（16.0%）,6°（15.5%）,1°（10.2%）,7°（10.0%）,11°（9.6%）,5°（9.0%）,9°（8.6%）,3°（8.1%）,10°（4.0%）,4°（3.2%）,8°（3.0%） and 2°（2.8%）,respectively.Rankings（rates） of biopsy point number were four biopsies（42.2%）,three biopsies（30.5%）,two biopsies（19.7%）,five biopsies（3.7%）,single biopsy（3.3%） and six biopsies（0.5%）.In single,two,three and four biopsies,the two most common biopsy locations were always 12° and 6°.Conclusion：12°,6°,1°,7° might be the four most susceptible locations of cervical lesions.Therefore,punch biopsy in these four locations might be of importance in improving early detection of cervical lesions in rural areas in the absence of colposcopy.
作者
丛青
江宁红
隋龙
Cong Qing Jiang Ninghong Sui Long(Cervical Disease Center, Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011)
出处
《现代妇产科进展》
CSCD
北大核心
2017年第9期666-669,共4页
Progress in Obstetrics and Gynecology
基金
上海市科委创新项目(No:16411950200)
上海市卫生和计划生育委员会课题(No:201344095)
关键词
无阴道镜
宫颈病变
点活检
位置
Absence of colposcopy
Cervical lesions
Punch biopsy
Location
