阴道镜检查在宫颈癌筛查中的作用

The Role of Vaginal Cytology in Screening of Cervical Cancer

目的分析在宫颈癌筛查中,采取阴道镜检查的效果。方法整群选取2015年3月—2016年3月期间,在该院进行阴道镜检查的1 362例患者作为研究对象。所有患者给予阴道镜检查及宫颈刮片或液基细胞学检查。比较阴道镜检查结果与临床诊断、病理诊断的符合率。结果 1 362例阴道镜检查,1 052例行活检,慢性宫颈炎症858例,CIN1级92例,CIN2-3级95例,宫颈癌5例,可疑癌2例（其中LEEP刀后确诊1例）。阴道镜诊断与病理学诊断结果比较,宫颈癌的诊断符合率80%,CIN1级的诊断符合率86.9%,CIN2~3级的诊断符合率82.1%,,慢性宫颈炎症的诊断符合率97.3%。可以明显看出,阴道镜检查结果诊断符合率更接近于病理学诊断结果,组间差异有统计学意义。结论阴道镜检查具有敏感性高、无创伤、无痛苦的优势。在宫颈癌筛查中,使用该检查方法,可以选取重点部位定点活检,提高了诊断准确率,也可以动态化的观察到病变的发展与转归,为疾病的诊断与治疗提供了依据。因此,值得在临床上大力推广。

Objective To analyze the effect of cervical cancer screening in patients with cervical cancer. Methods Group selection from March 2015 to March 2016, 1 362 cases of patients with vaginal examination were studied. All patients were given vaginal cytology and cervical curettage or liquid based cytology test. To compare the coincidence rate between the results of vaginal examination and clinical diagnosis and pathological diagnosis. Results 1 362 cases of biopsy, 1 052 cases of chronic cervicitis, 92 cases of CIN1 grade, 95 cases of grade CIN2~3, 5 cases of cervical cancer, 2 cases of suspicious cancer（including 1 cases after LEEP knife）. Compared with the pathological diagnosis, the diagnosis of cervical cancer was80%, the rate of diagnosis of CIN1 grade was 86.9%, the rate of diagnosis of grade CIN2~3 was 82.1%, and the rate of diagnosis of chronic cervicitis was 97.3%. It can be clearly seen that the diagnostic accuracy of the results of the diagnostic accuracy of the Results of the diagnosis of the pathological diagnosis, the difference between the groups was obvious, with statistical significance. Conclusion The advantages of high sensitivity, no trauma, no pain. In cervical cancer screening using this method, can select parts of the focus directed biopsy, improve the accuracy of diagnosis, can also be the development of dynamic observation of the lesions and prognosis has provided the basis for the diagnosis and treatment of disease.Therefore, it is worthy to be popularized in clinic.