摘要
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 application value of colposcopy combined with cervical smear in detection of cervical lesions. Methods：The married women underwent cervical cytological smear combined with colposcopy to screen cervical lesions,histopathological diagnosis was designed as gold standard,the results were analyzed. Results：Among 1 030 married women undergoing cervical smear,156 women underwent biopsy under colposcope and pathological examination;91 cases with chronic cervicitis,15 cases with human papillomavirus（HPV） infection,22 cases with cervical intraepithelial neoplasia（CIN） Ⅰ,8 cases with CIN Ⅱ,2 cases with CIN Ⅲ,and 6 cases with cervical cancer were found.Thirty-six cases were diagnosed as CIN by colposcopic RCI score,including 21 cases with CIN Ⅰ,9 cases with CIN Ⅱ,and 6 cases with CIN Ⅲ;the coincidence rate of colposcopic RCI score and pathological examination based on colposcopic biopsy was 94.74%（36/38）.Twenty-four cases was suspected of CIN Ⅲ by cervical cytological smear,14 cases were confirmed by pathological examination based on colposcopic biopsy,the coincidence rate was 58.33%（14/24）.There was significant difference in the coincidence rate of CIN between colposcopic RCI score and cervical cytological smear（P0.05）.The sensitivity,specificity,positive predictive value,and negative predictive value were 95.50%,89.26%,72.21%,and 95.85%,respectively. Conclusion：Cervical cytological smear combined with colposcopy used in cervical lesions screening can improve the diagnostic rates of cervical precancerous lesion and early cervical cancer,which can be used as one of the feasible methods to screen cervical precancerous lesion in the region.
出处
《中国妇幼保健》
CAS
北大核心
2012年第12期1898-1900,共3页
Maternal and Child Health Care of China
关键词
阴道镜
宫颈涂片
宫颈病变
Colposcope
Cervical smear
Cervical lesion
