260例电子阴道镜下图像特点与宫颈活检病理诊断的关系

Relationship between Characterictics of Cervical Images by Electronic Colposcopy and Pathological Results after Biopsy in 260 cases of Cervical Diseases

目的:探讨电子阴道镜下的宫颈异常表现图像与宫颈活检病理诊断的相互关系。方法:选择2011年9～11月就诊于本院阴道镜门诊的260例患者,以活检病理学诊断结果为标准,对组织病理学结果和阴道镜表现特点进行分析。结果:①电子阴道镜在宫颈疾病诊断中敏感性97.9%,特异性71.2%,阳性预测值89.7%,假阴性率2.1%;②阴道镜下扁平醋白上皮可出现在宫颈炎到CINⅢ的各级宫颈病变中,致密醋白上皮出现于CINⅡ及以上级别的宫颈病变中。二联征中CIN的检出率为77.4%,三联征和醋白上皮+非典型血管中CINⅢ及宫颈癌(ICC)的检出率分别是78.6%和72.4%。③不典型鳞状上皮(ASC)和(或)非典型腺细胞(AGC)出现在各级宫颈病变,在低度鳞状上皮内瘤变(LSIL)中CINⅠ的检出率为40.9%,在高度鳞状上皮内瘤变(HSIL)(包括HSIL+AGC)中CINⅡ、CINⅢ及ICC的检出率为96.9%。④宫颈表面是否光滑及糜烂程度与宫颈自身病变无关。结论:电子阴道镜是辅助诊断宫颈疾病的可靠而重要的手段,典型的异常阴道镜图像对诊断宫颈癌前病变和宫颈癌有重要价值。

Objective：To investigate the relationship between abnormal cervical images under colposcopy and pathological results in the cervical diseases. Methods：The clinic data of 260 patients who had colposcopic inspections and cervical biopsies in West China Second University Hospital between September and November in 2011 were retrospectively analyzed with cervical biopsy results as the standard. Results：①The sensitivity, specificity, positive predictive value, false negative rate of electronic colposcopy for cervical diseases were 97. 9%, 71.2%, 89. 7%, 2. 1% respectively. ②Flat acetowhite epithelium occurred in all types of cervical diseases from cervicitis to CIN Ⅲ, while dense acetowhite epithelium only occurred in CIN Ⅱ, CIN and invasive cervical carcinoma. The relevance ratio of CIN in twin signs was 77. 4% ; the relevance ratio of CIN Ⅱ and invasive cervical carcinoma in triple signs and acetowhite epithelium with atypical blood vessels were 78.6%, 72.4% respectively. ③ASC/AGC presented to all stages of cervical diseases, from cervicitis to cervical carcinoma. And the relevance ratio＇of CIN I in LSIL was 40.9%, while in HSIL it was 96.9% for CINⅡ, CIN Ⅱ and invasive cervical carcinoma. ④Cervical lesions itself had no correlations with the surface being smooth or not and the degree of erosion. Conclusions： Electronic colposcope is an important and reliable clinical examination method, and the typical abnormal cervical images under colposcopy have a critical diagnostic value in CIN and cervical cancer.