宫颈细胞学和电子阴道镜在宫颈病变早期诊断中的应用

Combination usage of cytology and digital colposcopy:application to the early diagnosis of cervical lesions

目的:探讨细胞学和电子阴道镜在宫颈病变早期诊断中的价值。方法:回顾性分析我院2005年10月至2006年2月就诊的1 930例患者进行液基超薄细胞技术检查(TCT),对150例细胞学阳性及未明确诊断意义的不典型鳞状和(或)腺细胞(ASCUS/AGUS)病变进行阴道镜活检和组织病理学诊断。结果:1930例患者中正常范围内占35%,宫颈炎性病变占58.1%,未明确诊断意义的不典型鳞状细胞(ASCUS)及不典型腺细胞(AGUS)占5%,宫颈上皮内瘤样变占1.8%,宫颈癌占0.1%,HPV感染阳性16例。其中,未明确诊断意义的(AS-CUS)及AGUS 100例,低度鳞状上皮内病变(LSIL)40例,活检证实宫颈上皮内瘤变(CINⅠ)28例,CINⅡ3例,高度鳞状上皮内病变(HSIL)10例,活检证实CINⅡ3例,原位癌2例。其中,宫颈上皮内瘤样变HPV感染率为41%,宫颈癌HPV感染率为100%。结论:育龄妇女应定期进行液基细胞学筛查,细胞学与阴道镜下活检联合应用能提高宫颈病变的检出率。

Objective： To evaluate the diagnostic methods for cervical lesions,including cervical cytological smear,colposcopic examination and colposcopicaUy multiple biopsy.Methods： 150 patient with abnormal cervical smears underwent colposcopic examinations and biopsies. The result of cytological screening compared with the results of histologic-colposcopic diagnosis were analyzed retrospeetively. Results： Amongl00 cases with atypical squamous cell of undetermined significance（ASCUS）, 40 cases with low grade squamous intraepithelial lesion（LSIL）, 28 were cervical intraepithelial neoplasia Ⅰ （CIN Ⅰ）, 3 were cervical intraepithelial neoplasia Ⅱ （CIN Ⅱ ）, Among 10 cases with high grade squamous intraepeithelial lesion（HSIL） ,3 were cervical intraepithelial neoplasia Ⅱ （CIN Ⅱ）, 2 were carcinoma in situ （CIS）. Conclusions： Patient with abnormal cytological finding should undergo colpscopic examination and multiple biopsies for further diagnosis.