宫颈上皮内瘤变患者活检与锥切术后病理结果比较

Comparison Between Cervical Biopsy Results and Histopathological Results after Conization of Cervix for Cervical Intraepithelial Neoplasia

目的:比较宫颈上皮内瘤变患者宫颈多点活检结果与锥切术后组织病理结果的差异,评价宫颈多点活检在宫颈上皮内瘤变诊断中的准确性。方法:选择行阴道镜下多点活检、随后行宫颈锥切术的宫颈病变患者45例,均分别行HE染色及免疫组织化学P16、Ki-67检测,比较宫颈多点活检诊断与锥切术后组织病理诊断的符合率。结果:27例宫颈锥切组织病理诊断结果与术前活检病理诊断结果符合(60.0%),18例结果不符合(40.0%);3例锥切术后组织病理结果较多点活检严重,占不符合例数的16.7%,占总例数的6.7%;15例锥切术后组织病理诊断较多点活检轻,占不符合例数的83.3%,占总例数的33.3%。结论:仅根据宫颈多点活检结果诊断宫颈上皮内病变具有局限性。

Objective： To compare the differences between multiple point cervical biopsy results of cervical intraepithelial neoplasia and histopathological results after conization of cervix operation and evaluate diagnostic accuracy of multiple point cervical biopsy in diagnosis of cervical intraepithelial neoplasia. Methods： Forty-five cases of patients with cervical lesions who underwent multiple point cervical biopsy under colposcope followed by conization of cervix were enrolled in this study. HE staining and immunohistochemical detection of P16 and Ki-67 were conducted on them and the diagnostic accordance rates were compared between multiple point cervical biopsy diagnosis and histopathological diagnosis after conization of cervix operation. Results： The histopathological diagnosis results of 27 cases of conization of cervix operation comformed to preoperative biopsy pathology diagnosis results （ diagnostic accordance rate was 60.0% ） while the results of 18 cases did not comform to, accounting for 40. 0%. There were 3 cases in which histopathological diagnosis results were worse than those of multipie point cervical biopsy, accounting for 16.7% in non-conformity cases or 6.7% in total. There were 15 cases in which histopathological diagnosis results were milder than those of multiple point cervical biopsy, accounting for 83.3% in non-conformity cases or 33.3% in total. Conclusion： Clinical diagnosis of cervical intraepithelial lesions only according to the results of cervical biopsy cannot guarantee diagnostic accuracy.