宫颈刮片应用于妇科体检中对宫颈癌筛查的价值

Value of Cervical Smears in the Application of Cervical Cancer Screening in Gynecological Examination

目的探讨分析宫颈刮片应用于妇科体检中对宫颈癌筛查的价值。方法选取2016年7月至2017年11月我院妇科体检行宫颈刮片筛查2 871例受检者作为研究对象,对宫颈刮片筛查不典型鳞状细胞(ASCUS)及以上受检者行阴道镜病理活检,以病理检查为"金标准",判定宫颈刮片在妇科体检中对宫颈癌筛查的价值。结果 2 871例受检者中,标本送检不符合35例,予以剔除,有效2 836例,其中NILM 2 015例, ASCUS 624例, ASC-H 68例, LSIL 53例, HSIL 49例, SCC 17例,AGC 6例, AC 4例。821例宫颈刮片筛查ASCUS及以上受检者,经阴道镜取宫颈组织病理检查,筛查出CINⅠ级58例, CINⅡ级71例, CINⅢ级13例。宫颈刮片筛查在宫颈癌中的诊断灵敏度为80.99%,特异性为97.10%,阳性预测值为89.15%,阴性预测值为94.55%,与病理检查诊断结果比较差异有统计学意义(P <0.05)。结论宫颈刮片在妇科体检中对宫颈癌有重要筛查价值,经宫颈刮片筛查后行阴道镜宫颈组织病理检查,可显著提高宫颈癌的诊断率。

Objective To explore and analyze the value of cervical smears in the application of cervical cancer screening in gynecological examination. Methods 2 871 examiners undergoing gynecological examination and cervical smear screening in our hospital from July 2016 to November 2017 were selected as the research objects. The examiners with cervical smear screening of atypical squamous cells of undetermined significance（ASCUS） and above received colposcopic pathological biopsy. Taking pathological examination as the ＂gold standard＂, the value of cervical smears in the application of cervical cancer screening in gynecological examination was determined.Results Among 2 871 cases of examiners, 35 cases not conforming to the detection were excluded, and 2 836 cases were effective, including2 015 cases of NILM, 624 cases of ASCUS, 68 cases of ASC-H, 53 cases of LSIL, 49 cases of HSIL, 17 cases of SCC, 6 cases of AGC, 4 cases of AC. 821 cases of examiners with cervical smear screening of ASCUS and above received colposcopic pathological biopsy. The cervical tissue examined by colposcopy showed 58 cases of CIN Ⅰ, 71 cases of CIN Ⅱ, and 13 cases of CIN Ⅲ. The diagnostic sensitivity,specificity, positive predictive value and negative predictive value of cervical smear screening in cervical cancer were 80.99%, 97.10%,89.15% and 94.55%, had statistical difference with the results of pathological examination（P 0.05）. Conclusions Cervical smears have important screening value for cervical cancer in gynecological examination. Colposcopic pathological biopsy of cervical tissue after cervical smear screening can significantly improve the diagnostic rate of cervical cancer.