影响阴道镜下宫颈活检准确性的相关因素分析

Analysis of related factors affecting the accuracy of cervical biopsy under colposcopy

目的分析影响阴道镜下宫颈活检准确性的相关因素。方法选取医院诊断为宫颈高级别上皮内病变行宫颈锥切术的760例患者临床资料,对阴道镜下宫颈活检病理结果及宫颈锥切术后的病理结果的符合率进行统计分析,判断阴道镜下宫颈活检的准确性,分析影响活检结果准确性的相关因素。结果绝经前与绝经后患者符合率分别为87. 59%和72. 22%,差异有统计学意义(χ~2=24. 06,P <0. 01);有宫颈治疗史与无宫颈治疗史的患者符合率分别为77. 30%和85. 76%,差异有统计学意义(χ~2=6. 803,P <0. 01);宫颈转化区完全可见及不完全可见患者符合率分别为86. 20%和81. 98%,差异无统计学意义(χ~2=2. 502,P> 0. 05)。结论患者绝经状态及是否有宫颈治疗史是影响阴道镜下宫颈活检准确性的相关因素,宫颈转化区类型影响阴道镜下观察,但可通过多点活检及宫颈管搔刮等提高活检准确率。

Objective To analyze the factors influencing the accuracy of cervical biopsy under colposcopy. Methods The clinical data of 760 patients with high-grade intraepithelial lesions who underwent cervical conization were selected. Statistical analysis and comparison of pathological results of cervical biopsy under colposcopy and post-conization cervical pathological results,analysis of the relevant factors affecting the accuracy of biopsy results. Results The coincidence rate of pathologi- cal results between premenopause and postmenopause was 87. 59% and 72. 22% (P <0. 01). The coincidence rate of pathological results between patients with and without cervical treatment history was 77. 30% and 85. 76%,respectively (P < 0. 01). The coincidence rates of pathological results between complete and incomplete cervical transformation areas were 86. 20% and 81. 98% respectively (P >0. 05). Conclusion The menopausal status and the history of cervical treatment are the related factors that affect the accuracy of cervical biopsy under colposcopy. Although the type of cervical transition zone affects the intuitive observation under colposcopy,the accuracy of biopsy can be improved by multi-point biopsy and scraping of cervical canal.