光电阴道镜配合宫颈管诊刮术对子宫颈癌前病变的筛查价值

The Value of Photoelectricity Colposcope and Endocervical Curettage on Screening Cervical Precancerous Change

目的：评价光电阴道镜及宫颈管刮片对子宫颈癌前病变的筛查价值。方法：对900例门诊宫颈病变患者进行前瞻性研究，阴道镜检查并在阴道镜下行定点活检的同时进行宫颈管诊刮涂片。两种检查方法与病理学检查相对照。结果：900例患者中病理结果回报子宫颈癌前病变60例，发生率为6．7％，其中子宫颈上皮内瘤变42例，宫颈原位癌18例。阴道镜对CIN或CIS的诊断符合率66．7％，宫颈管刮片对CIN或CIS的阳性符合率16．7％。阴道镜检查和／或子宫颈管刮片二者结合阳性率75％，二者结合阳性率提高不明显，阴道镜检查与阴道镜联合子宫颈管刮片之间无差异性，P〉0．05。结论：光电阴道镜在官颈上皮内瘤变及宫颈癌早期诊断中具有重要作用，阴道镜下活组织病理检查阳性率高，宫颈管刮片在子宫颈癌前病变早期诊断中阳性率低，没有必要对子宫颈病变常规行宫颈管诊刮术，但对阴道镜检查不满意及临床可疑病例仍然具有重要作用。

Objective： To describe the value of photoelectricity colposcope and endocervical scraping smear on screening cervical precancerous change. Methods： 900 cases with cervical changes in clinics were studied after biopsies under colposcope and endocervical scraping smear. The two methods refer to the pathobiology test. Results： Among the 900 cases, 60 cases were found with cervical precancerous change from pathobiology results and the incidence rate is 6.7 % , in which 42 cases were found with CIN, 18 cases with carcinoma in situ of cervix. The diagnose accordance rate of colposcope on CIN or CIS is 66. 7% , wich of endocervical scraping smear is 16.7 % , and wich of the combination of the two methods is 75%. The positive rate of the combination of colposcope and endocervical scraping smear was not improved significantly. And the positive rate of he combination of colposcope and endocervical scraping smear was not significantly higher than that of colposcope with P 〉 0.05. Conclusions： The photoelectricity colposcope plays a important part in early diagnosis of cervical intraepithelial neoplasm（CIN） and cervical cancer. The positive rate of colposcope biopsies is higher than that of the endocervical scraping smear on the early diagnosis of cervical precancerous change. It is not necessary to make the endocervical scraping smear conventionally, but it is still important for the doubtful cases which are not content with colposcope tests.