摘要
目的探讨宫颈环形电切术(LEEP)和阴道镜活检在诊断宫颈上皮内瘤变(CIN)中的价值。方法对门诊阴道镜活检诊断为CIN的患者123例行LEEP,比较其病理诊断结果的差异。结果123例患者LEEP后病检结果:慢性宫颈炎16例,CINⅠ级21例,Ⅱ级40例,Ⅲ级40例,早期浸润癌4例,浸润癌2例。阴道镜下活检结果为CINⅠ、Ⅱ级和Ⅲ级的与LEEP后病检结果的符合率分别为43.9%、73.8%、85.0%,总符合率为67.5%。其中诊断过度者19例(15.5%),诊断不足者21例(17.1%),宫颈癌漏诊率为4.9%。阴道镜下活检对诊断CINⅡ、Ⅲ级的准确率要高于CINⅠ级,两者相比较有差异(P<0.01)。阴道镜下活检诊断CINⅢ级的患者,其漏诊癌的比例较CINⅠ级和Ⅱ级高(P<0.05)。结论阴道镜活检是诊断CIN的一种简单而有效的方法,但存在一定的局限性,LEEP可以弥补阴道镜活检的缺陷,提高诊断的准确率。
Objective To explore the value of loop electmsurgical excision procedure（LEEP） and cervical biopsy by colposcopy in the diagnosis of cervical intraepithelial neoplasia （CIN）. Methods Retrospective analyze out-patient information of 123 cases of CIN diagnosised by cervical biopsy by colposcopy, which were compared with pathological results by LEEP. Results There were 16 Chronic cervicitis,21 CIN 1,40 CIN II,40 CIN III,4 early in- vasive carcinoma,2 Invasive carcinoma in 123 patients diagnosis by LEEP. Coincidence rate of pathological results CIN I, CIN II, CIN III between cervical biopsy by colposcopy and LEEP was 43.9%, 73.8% , 85.0%, respectively, and the total Coincidence rate was 67.5%. 19 cases（ 15.5% ）were in higher grade in the pathological results of colposcopic multiple biopsy than in those of LEEP. and other 21 cases（ 17.1% ）were in lower grader. The missed diagnosis rate of cervical cancer was 4.9%. Accuracy of cervical biopsy by colposcopy on CIN II and CIN III was higher than that of CIN I. There was significant difference between them（ P 〉 0.01 ）. The missed diagnosis rate of cervical cancer by cervical biopsy under colposcopy in CIN III was higher than that in CIN I and CIN II（P 〈0.05）. Conclusion Cervical biopsy by colposcopy is a simple, effective method in the diagnosis of CIN, but there are some limitations. LEEP can make up the defects of cervical biopsy by colposcopy and improve the accuracy of diagnosis.
出处
《中国临床保健杂志》
CAS
2010年第1期56-58,共3页
Chinese Journal of Clinical Healthcare
