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目的:探讨阴道镜联合宫颈涂片检测宫颈病变的临床应用价值。方法:对已婚妇女行宫颈细胞学涂片联合阴道镜检查对宫颈病变进行筛查,以组织病理学诊断为金标准,对结果进行分析。结果:接受宫颈涂片检查的1 030例已婚妇女中有156例行阴道镜下活检病理诊断,其中慢性宫颈炎91例,HPV感染15例,CINⅠ22例,CINⅡ8例,CINⅢ2例,宫颈癌6例。经阴道镜下RCI评分诊断CIN 36例,其中CINⅠ21例、CINⅡ9例、CINⅢ6例;与阴道镜下活检病理诊断的符合率为94.74%(36/38)。宫颈涂片细胞学检查巴氏Ⅲ级以上可疑CIN 24例,其中阴道镜下活检病理证实14例,宫颈涂片细胞学检查诊断符合率为58.33%(14/24)。阴道镜下RCI评分诊断CIN符合率与宫颈涂片细胞学检查诊断符合率相比差异有统计学意义(P<0.05)。统计学处理得出阴道镜诊断CIN的敏感性为95.50%,特异性为89.26%,两者联合的阳性预测值为72.21%,阴性预测值为95.85%。结论:宫颈细胞学涂片联合阴道镜检查筛查子宫颈病变能提高宫颈癌前病变及早期宫颈癌的诊断率,可作为该地区筛查宫颈癌前病变的可行方法。
Objective: To explore the clinical value of colposcopy combined with cervical smears in detecting cervical lesions. Methods: Cervical cytology smears and colposcopy of married women were used to screen the cervical lesions. The histopathological diagnosis was the gold standard, and the results were analyzed. Results: Of the 1 030 married women who underwent cervical smear examination, 156 cases were diagnosed colpososcopically by biopsy, including 91 cases of chronic cervicitis, 15 cases of HPV infection, 22 cases of CINⅠ, 8 cases of CINⅡ, 2 cases of CINⅢ, example. There were 36 CIN cases diagnosed by colposcopic RCI, of which 21 cases were CINⅠ, 9 cases were CINⅡ and 6 cases were CINⅢ. The coincidence rate with colposcopy biopsy was 94.74% (36/38). Cervical smear cytology Pap Ⅲ grade suspicious CIN 24 cases, including colposcopic biopsy confirmed in 14 cases, cervical smear cytology diagnosis of coincidence rate was 58.33% (14/24). The colposcopy RCI score CIN coincidence rate and cervical smear cytology diagnostic accuracy was significantly different (P <0.05). The results showed that the sensitivity of colposcopy in diagnosing CIN was 95.50% and the specificity was 89.26%. The positive predictive value of combination of the two was 72.21% and the negative predictive value was 95.85%. Conclusion: Cervical cytology smears combined with colposcopy screening of cervical lesions can improve the diagnostic rate of cervical precancerous lesions and early cervical cancer, which may be used as a feasible method for screening precancerous lesions of cervical cancer in the area.