阴道镜结合病理组织学检查在宫颈病变中的应用观察

Application observation of colposcopy combined with histologic examination in cervical lesions

目的观察阴道镜结合病理组织学检查在宫颈病变中的应用。方法我院妇科门诊2008年1月~2016年12月2388例肉眼观察异常的宫颈疾病患者,分别经细胞学检查、阴道镜及阴道镜直视下宫颈活组织检查,比较阴道镜结合病理组织学检查和细胞学检查结果。结果细胞学检查NILM 1493例(62.52%),ASC-US 140例(5.86)%,ASC-H 313例(13.11%)、LSIL 153例(6.41%)、HSIL 243例(10.30%)、SCC和AC 43例(1.80%);阴道镜检查醋白上皮1515例(63.44%)、白嵌二联征365例(15.28%)、白嵌点三联征366例(15.33%)、可疑宫颈癌142例(5.95%);病理组织学检查慢性炎症1215例(50.88%)、CINⅠ502例(21.02%)、CINⅡ388例(16.25%)、CINⅢ188例(7.87%)、宫颈癌95例(3.98%);细胞学检查对宫颈病变、高级别宫颈病变、宫颈癌的灵敏度分别为75.36%、82.86%和88.1%,特异率分别为69.4%、70.2%、92.8%;阳性预测值分别为72.83%、59.75%、91.2%;阴性预测值分别为68.3%、89.5%、81.9%。结论细胞学检查有一定的漏诊和误诊率,阴道镜结合病理组织学检查可提高准确性,对治疗具有积极的指导意义。

Objective To observe the appliieation of colposeopy combined with histologic examination in ＇cervical lesions. Methods 2388 eases of abnormal cervical disease in department of gynaeeology of our hospital outpatient service from January 2008 to December 2016 were checked respectively by cytological examination, eolposeopy and cervical biopsy under colposeope directly at them. The colposcopy combined with histologie examination and eytologieal examination results were compared. Results In cytology, there Were NILM1493 cases （62.52%）, ASC- US140 cases （5.86） %, ASC - H313 cases （13.11%）, LSIL153 eases （6.41%）, HSIL243 eases （10.30%）, SCC and AC43 eases （1.80%）. In colposcope examination, there were 1515 eases （63.44%） of white vinegar epithelium, 365 eases （15.28%） of white embedded two joint sign, 366 cases （15.33%） of white embedded three joint sign, 142 cases （5.95%） of suspicious of cervical cancer. In histologie examination, there were 1215cases of chronic inflammation （50.88%）, CIN Ⅰ 502 cases （21.02%）, CIN Ⅱ 388 cases （16.25%）, CIN Ⅲ 188 cases （7.87%）, cervical cancer, 95 cases （3.98%）. The cervical lesions, high level eervical lesions, the sensitivity of cervical cancer of cytologic examination were 75.36%, 82.86% and 88.1%, respectively, specific rates were 69.4%, 70.2% and 69.4% respeetively. Positive predictive values were 72.83%, 59.75%, 91.2%. Negative predictive values of 68.3%, 89.5% and 81.9% respeetively. Conclusion Colposeopy combined with histologic examination can accurately diagnose pathological changes of cervical cancer and cervical cancer before level. It has a positive guiding significance to treatment.