电子阴道镜在宫颈疾病诊断中的临床应用

Clinical application of electronic colposcopy in diagnosis of cervical squamous intraepithelial lesions

目的探讨电子阴道镜在宫颈疾病诊断中的应用价值、临床意义及应用体会.方法收集我院2001年～2004年妇产科240例宫颈疾病患者,进行阴道镜检查并行宫颈活检组织学检查,结果进行回顾性分析、比较和总结.结果①电子阴道镜在诊断宫颈病变中敏感度为80.4%,特异度为87.8%,假阴性率(漏诊率)为4.3%,阳性预测值为83.9%;②阴道镜图像与组织学结果相比:醋白上皮符合率为66.7%,二联征符合率为77.8%,三联征符合率100%,可疑宫颈癌符合率100%;③宫颈疾病在年龄分布上,其中以30～39岁发病者所占比例最大(46.5%),为CIN发病高峰年龄.结论电子阴道镜检查技术诊断宫颈疾病结果准确可靠,有一定的应用价值,特别对CIN的早期诊断、早期治疗及降低宫颈癌的发生率有重要的指导意义.

Objective To investigate the clinical value, significance and experience of electronic colposcopy in diagnosis of cervical squamous intraepithelial lesions. Methods A total of 240 patients with cervical lesions underwent electronic colposcopy and biopsies followed by pathological examination. The diagnosis of colposcopy and pathology were analyzed, compared and summarized. Results ① The sensitivity, specificity and positive predictive value of electronic colposcopy in diagnosis of cervical squamous intraepithelial lesions were 80.4%, 87.8% and 83.9%, respectively. ② The consistent rates between 4 kinds of colposcopic signs such as acetowhite epithelium, twin signs, triple signs, cervical carcinoma and pathologic diagnosis of cervical lesions were 66.7%, 77.8%, 100%, 100%, respectively. ③ In age distribution, the highest proportion of these women with CIN was at 30 to 39 years old. Conclusions Electronic colposcopy can be a accurate diagnostic method in clinical practice. It is quite sensitive in diagnosis of cervical lesions, and can play important role in diagnosis and treating CIN at early stage, leading to decrease the incidence of cervical carcinoma.