阴道镜活检782例临床病理分析

Clinical and Pathological Analysis of 782 Cases of Biopsy under Colposcopy

目的:了解阴道镜活检和HPV感染在宫颈病变诊断中的价值。方法:分析782例行阴道镜下活组织检查并有病理结果患者的临床病理资料。结果:①782例共检出宫颈上皮内瘤变293例,包括CINⅠ139例(17.8%),CINⅡ90例(11.5%),CINⅢ64例(8.2%);宫颈浸润癌13例(1.7%);子宫内膜癌3例(0.4%);其余为:炎症451例(57.7%)、宫颈湿疣22例(2.8%)。②宫颈病理学阳性组(包括CIN和宫颈浸润癌)和病理学阴性组(包括炎症和宫颈湿疣)的HPV阳性率分别为52.0%和40.4%,差异有非常显著性(P<0.01)。③HPV阳性者较HPV阴性者年龄显著降低,差异有非常显著性(P<0.01)。结论:阴道镜检查对CIN和宫颈癌的早期诊断具有重要价值,HPV感染是宫颈癌和CIN的重要原因,HPV阳性者的年龄显著低于HPV阴性者。

Objective To evaluate the instructive value of biopsy under colposcopy and HPV infection in diagnosis of cervical lesions. Methods： 782 cases of biopsy under colposcopy were retrospectively analyzed. Results： 293 women were histopathologically confirmed to have CIN, including 139 （17.8%）CIN Ⅰ , 90 （11.5%）CIN Ⅱ, and 64 （8.2%） CIN Ⅲ; 13（1.6%） invasive cervical carcinoma, 3（0.4%）endometrial carcinoma, 22（2.8%）condyloma acuminate. In pathological positive group （including CIN and invasive cervical carcinoma） HPV positive were 52.0%, in cervicitis group 40.1% （ P〈 0.001 ）. Age in HPV positive group was significant younger than that in HPV negative group（ P〈0.01 ）. Conclusions： Colposcopy has an important role in early diagnosis of CIN and cervical carcinoma, in which HPV infection plays an important role. Age in HPV positive group was significant younger.