1602例农村妇女宫颈细胞学涂片配合阴道镜筛查宫颈疾病效果分析

Analysis on screening effect of cervical diseases by cervical cytological smear examination and colposcopy in 1602 rural women

目的:探讨宫颈细胞学巴氏涂片配合阴道镜检查对农村妇女宫颈疾病筛查的诊断价值。方法:对妇科门诊检查的1602例农村妇女行宫颈细胞学涂片及阴道镜检查,检出异常涂片176例,其中100例配合阴道镜检查,76例行肉眼碘试验活检(对照组),以组织学诊断为"金标准",并对结果进行分析。结果:1602例涂片中检出异常涂片176例(10.99%),对其中100例行阴道镜下活检,病理结果显示:宫颈上皮内病变(CIN)16例(16.00%);宫颈癌2例(2.00%);巴氏Ⅲ级以上可疑病变30例,活检证实CIN21例,与细胞学诊断符合率为70.00%,细胞学阴性临床可疑宫颈病变10例,活检证实CIN3例(3.00%);76例肉眼碘试验下活检诊断CIN10例(13.16%),宫颈癌1例,巴氏Ⅲ级以上29例,活检证实CIN7例,与细胞学诊断符合率为24.14%;细胞学阴性7例,CIN检出1例(14.29%),两者比较差异有统计学意义(P<0.05)。结论:宫颈细胞学涂片配合阴道镜检查能及早发现宫颈癌前病变,是方便、安全、经济、可靠的检查方法,尤其适用于农村妇女的宫颈疾病筛查。

Objeclive： To explore the diagnostic value of cervical cytological smear examination and colposcopy in screening of cervical diseases in rural women. Methods： 1 602 rural women received cervical cytological smear examination and colposcopy, 176 women had abnormal results and 100 women underwent colposeopy, 76 women underwent naked eye iodine test biopsy, histological diagnosis was gold standard, then the results were analyzed. Results： The abnormal detection rate of cervical cytological smear examination was 10. 99% （176/ 1 602）, 100 women underwent colposcopy, the results indicated that 16 women （16. 00% ） were found with cervical intraepithelial neoplasia （CIN） and 2 women （2. 00% ） were found with cervical cancer, 30 women above Pasteur Ⅲ were suspicious, then 21 women were diagnosed as CIN definitely by biopsy, the coincidence rate with cytological diagnosis was 70. 00%, 10 women with negative cytological results were suspected as cervical lesions, then 3 women （ 3.00% ） were diagnosed as CIN definitely by biopsy ; among 76 women undergoing naked eye iodine test biopsy, 10 women （ 13.16% ） were diagnosed as CIN definitely, one woman was diagnosed as cervical cancer, 29 women were diagnosed as above Pasteur IU, 7 women were diagnosed as CIN by biopsy, the coincidence rate with cytological diagnosis was 24. 14% ; among 7 women with negative cytological results, one woman （ 14. 29% ） was diagnosed as CIN, there was significant difference between the two groups （P 〈 0. 05 ） . Conclusion： Cervical cytological smear examination and colposcopy can find cervical precancerous lesion early, which is convenient, safe, economic and reliable, especially for screening of cervical diseases in rural women.