1067例阴道镜筛查宫颈病变的临床分析

Colposcopy Screening of Cervical Lesions: An Analysis of 1 067 Cases

目的评价电子阴道镜(简称阴道镜)对宫颈上皮内瘤样病变(CIN)的诊断价值。方法对2012年1-12月在五邑中医院妇科就诊的1 067例患者进行阴道镜检查,在阴道镜下可疑区或异常部位取活检送病理检查者296例,由病理检查确诊。结果 296例患者病理诊断:宫颈炎症165例,尖锐湿疣15例,CINⅠ58例,CINⅡ32例,CINⅢ18例,宫颈浸润癌6例,阴道癌2例。阴道镜诊断:宫颈炎153例,尖锐湿疣16例,CINⅠ71例,CINⅡ33例,CINⅢ16例,宫颈浸润癌5例,阴道癌2例。其中CINⅠ、CINⅡ、CINⅢ与病理学结果的准确率分别为63.38%、69.70%、75.00%。结论应用阴道镜通过对宫颈表面鳞状上皮、柱状上皮、转化区颜色、边界形态、血管和碘试验来评估病变,能及早发现宫颈癌前病变,是宫颈癌筛查方便安全、准确可靠的检查方法。

Objective To evaluate the value of colposcopy in diagnosing cervical intraepithelial neoplasia （CIN）. Methods The colposcopy showed suspected areas or abnormal sites in 296 of the 1067 patients who underwent eolposcopy in the department of gynecology of Wuyi traditional Chinese medicine hospital from January 2012 to December 2012. Cervical lesions were confirmed by pathological examination. Results Among the 296 patients, pathological results showed cervical inflammation in 165, condyloma acuminate in 15, CIN I in 58, CIN II in 32, CIN m in 18, invasive cervical cancer in 6, and vaginal cancer in 2. Colposcopy showed cervical inflammation in 153, condyloma acuminate in 16, CIN Ⅰ in 71, CIN Ⅱin 33, CIN Ⅲ in 16, invasive cervical cancer in 5, and vaginal cancer in 2. The accuracy of CIN Ⅰ , CIN Ⅱ and CIN Ⅲ diagnosed by colposcopy was 63.38%, 69.70% and 75.00%, respectively. Conclusion The colposeopy can early detect cervical lesions through observing cervical surface squamous epithelium, columnar epithelium, transformation zone color, boundary morphology, blood vessel and iodine test. Therefore, colposcopy is a safe, convenient, accurate and credible screening method for cervical carcinoma.