宫颈苏木素富染区活检直接镜下观察的研究

An observational study of women with positive cervical Hematoxylin coloration tests at Colposcopy

目的在电子阴道镜下观察复方苏木素宫颈染色富染区,可早期发现宫颈上皮内瘤样病变(CIN)病变区。方法35例液基薄层细胞检测异常病人,经阴道镜检查,选择嗜核染色剂苏木素复方制剂,对宫颈染色,同时行宫颈活检。结果随机选取35例苏木素染色后组织活检标本,分别将每一块活检组织部分快速冷冻切片(不再作任何染色处理),可直接镜下观察到富染区细胞核染色情况,与伊红染色情况一致。苏木素染色(+)可包括所有的CIN、宫颈癌和部分宫颈良性病变。苏木素染色(+)的CIN和宫颈癌病例与慢性宫颈炎、息肉等良性宫颈病变病例统计相比,差异有显著性(P<0.01)。苏木素染色越深则细胞异型性越高。结论在电子阴道镜下观察宫颈鳞状上皮苏木素细胞核富染区,可预知病理检查结果,可早期发现CIN病变区,减少漏诊率,减少不必要的活检,指导手术范围。

[Objective] To observe the relationship between the positive Cervical Hematoxylin Coloration Test under a eoloseope and the early detection of cervical intraepithelial neoplasia （CIN）. [Methodl Cervical Hema- toxylin Coloration Test was utilized under a eolposcope on the 35 patients of abnormal Thinprep Test. A tissue sam- ple was taken from positive test areas from performing the colposcopy. Frozen sections and HE paraffin-embedded sections of biopsy was conducted separately to observe the stained karyon. [Result] Positive Cervical Hematoxylin Coloration Test was found in 3 of 20（15%） samples with inflammation, 1 of 20（5%） cervical polyp, 14 of 20（70%） CIN （cervical intraepithelial neoplasia）, 2 of 20 （10%） cervical cancer. Positive Cervical Hematoxylin Coloration Test was significantly related to CIN and cervical cancer （P 〈0.01）. The darker the color of test, the lower the cell differentiation is. [Conclusion] An observational study of women with positive cervical hematoxylin coloration test and cervical vinegary acid test at Colposcopy can predict the pathology result, can discover cervical intraepithelial neoplasia （CIN） early, reduce the rate of misdiagnose, reduce unnecessary cervical biopsy, and give guidance to the scope of surgical operation. Key word： cervical intraepithelial neoplasia（CIN）; hematoxylin; colposcopy; biopsy; coloration