阴道镜检查在子宫颈病变诊治中的价值——附1894例分析

Value of colposcopy in the diagnosis and treatment for cervical lesions——analysis of 1894 cases

目的评价电子阴道镜检查在子宫颈病变诊治中的价值,调查中国医科大学附属第二医院妇科门诊子宫颈病变诊室就诊患者的疾病构成。方法回顾分析该院子宫颈病变诊室阴道镜检查1894例,评价阴道镜检查的诊断效能,同时计算疾病构成比。结果阴道镜检查诊断子宫颈病变的敏感性85.2%,特异性52.4%,符合率72%,阳性预测值72.6%。该院子宫颈病变诊室的疾病构成比中,子宫颈上皮内瘤变(cerivicalintraepithe-lialneoplasia,CIN)占56.0%,子宫颈癌占3.2%。结论阴道镜检查是子宫颈病变早期诊断不可或缺的辅助手段。阴道镜联合薄层细胞检查(thinprepcytologictest,TCT)可以提高筛查的阳性率。大型综合性医院妇科门诊的就诊患者中,CIN的疾病构成比很高,要积极对就诊患者进行规范的子宫颈癌防癌筛查,以防CIN和子宫颈癌的漏诊。

[Objective] To evaluate the value of electrocolposcopy in the diagnosis and treatment of cervical lesions and to investigate the disease constitute of the cervical lesions office in the gynecologic OPD of the Second Affiliated Hospital of China Medical University. [Methods] Review 1894 cases of colposcopy in our cervical lesion office. Evaluate the diagnosis efficacy of colposcopy and calculate the constituent ratio. [Resuils] The sensitivity, specificity and accuracy of colposcopy for cervical lesions in our hospital is 85.2%, 52.4%, 72% and 72.6% respectively. In our cervical lesion office, the constituent ratio of cervical intraepithelial neoplasia （CIN） is 56.0% and that of cervical carcinoma is 3.2%. [Conclusions] Colposcopy is an important aid means for the early diagnosis of cervical lesions. The association of colposcopy and Thinprep cytological test （TCT） can raise the positive ratio of screening. Among the patients in cervical lesions office in large general hospital, the constituent ratio of CIN is high. So it is necessary to give standard prevention screening against cervical cancer to reduce the missed diagnosis for CIN and cervical cancer.