宫颈上皮内瘤变诊断方法的比较

Comparison of the Diagnostic Methods of Cervical Intraepithelial Neoplasia

目的：进一步评价细胞学、阴道镜和组织病理学在宫颈病变诊断中的临床意义。方法：收集2004年1月～2005年12月福建医科大学附属第一医院537例宫颈病变患者的临床资料进行分析研究。结果：537例宫颈病变，直接阴道镜检查及病理组织学诊断CIN、宫颈癌占250例，发生率46．55％。其中217例宫颈液基薄层细胞学检查（TCT）配合阴道镜检查及组织学病理诊断CIN及宫颈癌发生率47．92％，TCT报告在ASCUS级别以上（包括LSIL、HSIL）阴道镜检及组织学病理诊断CIN及宫颈癌发生率66．37％，二者有显著差异。结论：TCT、阴道镜检查、组织病理学检查三个手段是诊断宫颈病变的常用方法，联合应用能显著提高宫颈上皮内瘤变的诊断水平。TCT是宫颈上皮内瘤变早期诊断首选筛查方法。

Objective： To evaluate the clinical value of the usage of cytology, colposcopy and histopathology in diagnosis of cervical lesions. Methods： From January, 2004 to December, 2005, the clinical data of 537 patiens of cervical lesions were studied. Results： Among 537 cases, 250 were diagnosed as cervical intraepithelial neoplasia（CIN） or cervical cancer by colposcopy and histopathology. The incidence was 46.55%. 217 cases were diagnosed as CIN or cervical cancer by the combination usage of thinprep cytologic test（TCT）, colposcopy and histopathology. The incidence was 47.92%. The grade above ASCUS（including LSIL and HSIL）through TCT were diagnosed as CIN or cervical cancer by colposcopy or histopathology, which incidence was 66.37% （P〈0.05）. Conclusion： TCT, colposcopy and pathohistology are common methods for the diagnosis of cervical lesions, the combination usage of them can improve the diagnosis rate of CIN. TCT is the capital method for CIN screening.