比较LEEP术后病理检查和阴道镜宫颈活检对宫颈癌前病变诊断结果的差异

Comparison of Pathological Examination between LEEP and Colposcopic Cervical Biopsy in Diagnosis of Cervical Precancerous Lesions

目的分析比较LEEP术后病理检查和阴道镜宫颈活检对宫颈癌前病变诊断结果的差异。方法方便选取2014年10月—2016年12月期间入该院诊疗的320例经宫颈细胞学检查和(或)人乳头状瘤病毒检测异常,或是上述筛查均正常而肉眼观察宫颈柱状上皮存在中度重度外翻的患者,所有病例均实施LEEP术后病理检查和阴道镜宫颈活检,对比两种检查诊断结果的差异性。结果阴道镜宫颈活检结果和LEEP术后组织病理检查相比总符合率为60.00%,诊断不足60例(18.75%)、诊断过度68例(21.25%)。相关因素分析结果发现,高级别CIN、细胞学检查HSIL及以上情况是阴道镜宫颈活检危险因素,可能发生漏诊。结论阴道镜宫颈活检具有一定宫颈癌前病变诊断价值,但存在较小微小浸润癌漏诊风险,对于筛查结果为高级别CIN或HSIL及以上情况者必要时行使LEEP术病理活检能显著提升诊断准确性。

Objective This paper tries to analyze the difference of diagnostic result between postoperative pathological examination of LEEP and colposcopy cervical biopsy for cervical precancerous lesions.Methods From October 2014 to December 2016 in this hospital,320 patients who were convenient selected abnormal in cervical cytology and(or)human papillomavirus(HPV)detection or were found normal in above examination with moderately severe valgus through macroscopic observation cervical columnar epithelium were selected to take postoperative pathological examination of LEEP and colposcopy cervical biopsy,and then compared the differences of two kinds of inspection diagnosis.Results Compared with postoperative pathological examination of LEEP,the total coincidence rate of colposcopy cervical biopsy was 60.00%,60 cases(18.75%)were insufficiently diagnosed and 68 cases(21.25%)were excessively diagnosed.Correlation factor analysis showed that high level CIN,cytological examination of HSIL and the situation above were the risk factors for cervical biopsy,and missed diagnosis could occur.Conclusion Colposcopy cervical biopsy has some value for cervical cancer lesion,but exists small tiny risk of missed infiltrating carcinoma diagnosis,thus postoperative pathological examination of LEEP is necessary to significantly improve the diagnostic accuracy when screening results are high grade CIN or HSIL and the situation above.