电子阴道镜下影像与宫颈活检病理诊断关系

Relationship between electronic colposcopic images and pathological diagnosis after cervical biopsy

目的通过电子阴道镜下的宫颈异常表现图像结合宫颈活检病理诊断探讨两种诊断相互关系及影响阴道镜检查的因素。方法选择2012年3月-2014年3月吉林大学中日联谊医院531例患者行电子阴道镜检查与宫颈活检诊断结果进行对比分析,以活检病理学诊断结果为标准,对组织病理学结果和阴道镜表现特点进行分析。结果阴道镜检查中扁平醋白上皮出现在宫颈炎到CINⅢ的各级宫颈病变中,致密的醋白上皮则出现于CINⅡ及以上级别的宫颈病变中;宫颈异常排液会出现在宫颈炎症及CIN阶段,不作为临床判断指征;宫颈表面是否光滑及糜烂程度与宫颈自身病变无关。结论电子阴道镜是辅助诊断宫颈疾病的可靠而重要的手段,典型的异常阴道镜图像对诊断宫颈癌前病变和宫颈癌有重要价值。

Objective To explore the relationship between abnormal cervical images under electronic colposcope and pathological diagnosis after cervical biopsy and the influencing factors of colposcopy. Methods The results of colposcopy and pathological diagnosis after cervical biopsy in 531 patients from the hospital from March 2012 to March 2014 were compared and analyzed,pathological diagnosis was gold standard,histopathological results and colposcopic performance characteristics were analyzed. Results In colposcopy,flat white vinegar epithelium appeared in cervical lesions from cervicitis to CIN Ⅲ,dense white vinegar epithelium appeared in CIN Ⅱ and cervical lesions above CIN Ⅱ; cervical abnormal drainage occurred in cervical inflammation CIN cases,which was not an indication of clinical judgment; cervical surface is smooth or not and the degree of cervical erosion were not correlated with cervical lesions. Conclusion Electronic colposcope is a reliable and important means of auxiliary diagnosis of cervical diseases,typical abnormal colposcopic images have an important value in diagnosis of cervical precancerous lesions and cervical cancer.