细胞学、组织学和阴道镜检查在宫颈病变中的诊断意义(附488例分析)

Colposcopy,Cytology and Histology in the Diagnosis of Cervical Disease:Analysis of 488 cases

应用细胞学、组织学和阴道镜检查，比较三者之间在宫颈病变中的诊断意义。结果表明，细胞学涂片检出核肥大、轻度核异质、中度核异质、重度核异质和可疑癌的病例中，阴道镜下病理活检ＣＩＮ和癌检出率分别为６．６６％、１１．１１％、２５．５８％、８０％和１００％，涂片未发现异常细胞者，阳性检出率为３．２６％。阴道镜下血管结构异常图像中，点状血管、镶嵌及异型血管病理阳性检出率分别为６４．０７％、７６．４７％和８３．３３％。结果提示：细胞涂片分级越高，阴道镜下病理活检阳性检出率越高，同时表明在异常阴道镜图像部位取活检，可克服盲目性。

To compare the diagnostic significance of colposcopy,cytology and histology in 488 patients with cervic disease.The results showed that nucleus abnormality,mild,moderate and serious dysplasia as well as carcinoma were diagnosed in cervical smear,of which,CIn and carcinoma diagnosed by biopsing under colposcopy were 6 66%,11 11%,25 58%,80% and 100%,respectively.Also,3 26% of patients with negatively cervical smear had colposcopic and histologic abnormality.For findings of punctation,mosaic pattern and abnormalitic vessel were graded at colposcopic examinations,the histologic diagnosis of CIN and carcinoma was 64 07%,76 47% and 83 33%,respectively.This study suggests that the higher graded lession in cell smear,the higher positive rate in biopsy.It is necessary to improve sensitivety and enhance diagnostic specifity using biopsy in colposcopic abnormalitic zone.