宫颈细胞学涂片联合阴道镜诊断宫颈病变的结果分析

Cytologic Examination of Cervical Smear Combined with Biopsy under Colposcopy to Diagnose Cervical Squamous Intraepithelial Lesions

目的:评价宫颈细胞学涂片配合阴道镜检查对子宫颈病变的诊断价值。方法:对247例来本院行宫颈涂片检 查者进行阴道镜检查和镜下活组织病理检查,对子宫颈病变进行筛查和诊断,以组织学诊断为金标准,对结果进行比 较分析。结果:247例宫颈涂片检查,异常涂片127例(51.41%),病理结果显示:子宫颈鳞癌2例(0.81%);宫颈上 皮内瘤样变(CIN)15例,其中CINⅠ10例(4.05%),CINⅡ2例(0.81%),CINⅢ3例(1.21%);HPV感染81例 (32.79%),其中湿疣样变68例,宫颈湿疣13例;急慢性宫颈炎149例(60.32%)。宫颈涂片细胞学检查诊断CIN符 合率为12.5%,阴道镜检查对CIN的诊断符合率为86.67%,两者比较有统计学差异(P<0.01)。结论:采用宫颈细 胞学检查配合阴道镜下病理检查能提高宫颈癌前病变诊断的准确率,及早进行治疗。

Objective: To evaluate the efficiency of cytologic examination of cervical smear combined with biopsy under colposcopy in diagnosis of cervical squamous intraepithelial lesions. Methods: From March 2002 to July 2004, there were 247 women accepting the screening for cervical lesion by cytologic smear combined with biopsy under colposcopy in our institute. Pathologic examization of biopsy under colposcopy was assumed as 'gold standard'. Results: Among 247 cases, 127 cases (51.41%) were diagnosed as abnormal by cytologic smear. Results from pathologic examination shown that 2 cases with cervical squamous intraepithelial cancer, 15 with cervical intraepithelial neoplasia (CIN) of which 10 cases of CIN I, 2 of CIN II and 3 of CIN III, 81 (32.79%) with HPV infections, 68 with condylomatoid disease, 13 with cervical condylomat acuminate, and 149 (60.32%) with acute or chronic cervical infections. Coincident rate of diagnosing CIN was 12.5% and 86.67% for cytologic examination of cervical smear and for colposcopy examination, respectively. The difference of coincident rates was statistically significant (P<0.01) .Conclusion: The occurrence of HPV infections is increasing recently, and cytologic examination of cervical smear combined with biopsy under colposcopy are recommended to be as routine screening to identify precancerous lesions.