阴道镜诊断、阴道镜活检与阴道镜超高频电波刀在子宫颈上皮内瘤变诊断中效果对比研究

Effect of colposcope diagnosis,colposcopy biopsy and colposcope uhf radio knife( LEEP) in the diagnosis of cervical intraepithelial neoplasia(CIN)

目的：探究与分析阴道镜诊断、阴道镜活检与阴道镜超声高频电波刀在子宫颈上皮内瘤变诊断中效果。方法：回顾性分析我院自2013年5月至2015年5月收治的120例门诊患者的临床资料,全部患者均在我院接受阴道镜检查、阴道镜活检与阴道镜LEEP,对比阴道镜拟诊分别与阴道镜下宫颈活检、阴道镜下LEEP活检结果及阴道镜图像特征对CIN的诊断价值。结果：阴道镜图像特征拟诊CINⅠ的敏感性明显高于CINⅡ及CINⅢ,具有显著差异（χ-2=22.87,P〈0.05;χ-2=5.29,P〈0.05;）。阴道镜图像特征拟诊CINⅠ的特异性与CINⅡ及CINⅢ相比有明显差异（χ-2=5.52,P〈0.05;χ-2=15.58,P〈0.05）。阴道镜拟诊与阴道镜下LEEP活检符合率分别为CINⅠ（68.66%）、CINⅡ（44%）、CINⅢ（61.9%）及浸润癌（100.00%）。阴道镜拟诊与阴道镜下宫颈活检诊断符合率分别为CINⅠ（71.64%）、CINⅡ（52%）、CINⅢ（28.57%）及浸润癌（28.57%）阴道镜下LEEP活检与阴道镜下活检的CINⅠ及CINⅡ诊断符合率相比均无明显差异（χ-2=0.15,P〉0.05;χ-2=0.32,P〉0.05）。阴道镜拟诊同阴道镜下LEEP活检的CINⅢ及浸润癌诊断符合率较同阴道镜下宫颈活检的符合率相比均明显偏高,具有显著差异（χ-2=4.71,P〈0.05;χ-2=7.78,P〈0.05）。结论：阴道镜在诊断子宫颈上皮内瘤变中具有重要的应用,阴道镜LEEP活检较单独阴道镜活检具有一定的优越性,值得推广与应用。

Objectives： To explore and analyze the effect of colposcope diagnosis,colposcopy biopsy and colposcope high frequency ultrasound waves knife（ LEEP） in the diagnosis of cervical intraepithelial neoplasia（ CIN）. Methods： A retrospective analysis of the clinical data of 120 clinic patients in our hospital from May 2013 to May 2015 was conducted. All the patients underwent colposcope examination,colposcopy biopsy and colposcope LEEP. The results of cervical biopsy under colposcope and LEEP biopsy under colposcope were compared and the diagnostic value of vaginal mirror image characteristics to CIN. Results： The sensitivity of colposcope image characteristics examination CIN Ⅰ was significantly better than CIN Ⅱ and CIN Ⅲ,with significant difference（ χ-2=22. 87,P〈0. 05; χ-2= 5. 29,P〈0. 05）. The specificity of colposcope image characteristics examination CIN Ⅰwas significantly better than CIN Ⅱ and CIN Ⅲ,with significant difference（ χ-2= 5. 52 P〈0. 05; χ-2= 15. 58,P〈0. 05）. The coincidence rate of colposcopy examination and LEEP biopsy under colposcope was CIN Ⅰ（ 68. 66%）,CIN Ⅱ（ 44%）,CIN Ⅲ（ 61. 9%） and infiltrating carcinoma（ 100. 00%） respectively. The coincidence rate of colposcopy examination and cervical biopsy under colposcope was respectively CINⅠ（ 71. 64%）,CINⅡ（ 52%）,CIN Ⅲ（ 28. 57%） and infiltrating carcinoma（ 28. 57%）. Difference in the coincidence rate between LEEP biopsy under colposcopy and biopsy under colposcope CIN Ⅰ and CIN Ⅱ was not significant（ χ-2= 0. 15,P〈0. 05; χ-2= 0. 32,P〈0. 05）. The CIN Ⅲ and infiltrating carcinoma diagnosis coincidence rate of LEEP biopsy under colposcope was obvious higher than cervical biopsy under colposcope diagnosis with significant difference（ χ-2= 4. 71,P〈0. 05; P〈0. 05）. Conclusion： Colposcopy has important application value in the diagnosis of cervical intraepithelial neoplasia,and the colposcopy LEEP biopsy is better than simple colposcopic biopsy,which is worthy of popularization and application.