宫颈刮片与阴道镜检查在诊断宫颈上皮内瘤变中的临床应用

Cervical Smears and Colposcopy in the Diagnosis of Cervical Intraepithelial Neoplasia Clinical Application

目的探讨宫颈刮片与阴道镜检查在诊断宫颈上皮内瘤变(CIN)的临床应用。方法通过对100例有接触性出血等临床可疑症状的CIN患者分别行宫颈刮片和阴道镜检查,然后以病理组织学诊断为金标准,用敏感性、特异性、假阴性率、假阳性率及诊断符合率进行对比分析。结果 386例患者行病理组织血诊断后确诊93例患者异常,其中CINⅠ38例、CINⅡ26例、CINⅢ10例、HPV感染伴部分CIN改变16例、微小浸润癌3例。阴道镜检查结果与宫颈刮片细胞学检查结果比较,其诊断敏感性、假阳性率、假阴性率、诊断符合率均差异均有统计学意义(均P<0.05),而特异性差异无统计学意义(P>0.05)。结论将宫颈刮片与阴道镜检查联合使用,镜下定位取活体组织进行病理诊断,既避免常规四点活检的盲目性,又能减少各自的假阴性率及假阳性率,降低漏诊率,提高诊断率。

Objective To study the cervical smear and colposcopy examination in the diagnosis of cervical intraepithelial neoplasia（CIN）in clinical application.Methods Through the 100 cases had contact with suspected symptoms of bleeding in patients with CIN underwent cervical smears and colposcopy,then histopathological diagnosis as the gold standard,specificity,false negative rate,false positive rate and with sensitivity diagnosis rate were analyzed.Results In 386 cases of patients with pathological tissue blood diagnosis confirmed after 93 patients with abnormal,of which 38 cases of CIN Ⅰ and CIN Ⅱ in 26 cases,10 cases,CIN Ⅲ HPV infection with part of the CIN changes in 16 cases,micro invasive carcinoma in 3 cases.Comparison of the results of colposcopy and cervical scraping cytology results,the diagnostic sensitivity,false positive rate and false negative rate,diagnosis coincidence rate is a statistically significant difference（P〈0.05）,but no significant specific differences（P〉0.05）.Conclusion The cervical smear and colposcope examination used in combination,the microscopic positioning biopsy for pathological diagnosis.Both avoid the blindness of conventional biopsy at four o＇clock,and can reduce their rate of false negative and false positive rate,reduce missed diagnosis,improve the diagnostic rate.