阴道镜检测和颈管内膜刮取术在HSIL诊断中的应用研究

Application of Colposcopy and Endocervical Scraping in the Diagnosis of HSIL

目的:研究阴道镜检测与颈管内膜刮取术在高级别子宫颈病变(HSIL)诊断中的应用价值.方法:选取我院门诊2017年1月至2018年1月就诊的68例可疑HSIL患者,均进行阴道镜检测及颈管内膜刮取术,用宫颈环形电切术治疗的病理结果为黄金标准.分析阴道镜检测与颈管内膜刮取术在宫颈上皮内瘤变(CIN)诊断中的价值.结果:术后病变诊断CINⅠ病变16例、CINⅡ病变24例、CINⅢ病变18例及浸润性癌病变10例;阴道镜与颈管内膜刮取术诊断CINⅠ病变10例、CINⅡ病变20例、CINⅢ病变22例及浸润性癌病变6例,阴道镜检测与颈管内膜刮取术诊断结果和术后病理诊断结果的相符率为73.53%(50/68),不符合者为26.47%(18/68),诊断过度者为5.88%(4/68),诊断不足者为20.59%(14/68).阴道镜检测与颈管内膜刮取术和术后病理对CINⅠ、CINⅡ、CINⅢ及浸润性癌的诊断比较无统计学差异(P>0.05).结论:阴道镜检测与颈管内膜刮取术为防治子宫颈癌变的重要手段,能够一定程度的增加病理活检准确性,为其临床治疗提供可靠依据.

Objective: To study the value of colposcopy and endocervical curettage in the diagnosis of high-grade cervical lesions (HSIL). Methods: 68 suspected HSIL patients from January 2017 to January 2018 were selected from outpatient clinic of our hospital,all performed colposcopy and endocervical scraping, the pathological results of the hysterectomy were the gold standard. To analyze the value of colposcopy and endocervical scraping in the diagnosis of cervical intraepithelial neoplasia (CIN). Results: 16 cases of CINI lesions, 24 cases of CINII lesions, 18 cases of CINIII lesions and 10 cases of invasive cancer lesions were diagnosed by postoperative lesions. 10 cases of CINI lesions, 20 cases of CINII lesions, 22 cases of CINIII lesions and 6 cases of invasive cancer were diagnosed by colposcopy and endotracheal curettage. The coincidence rate between colposcopy and endoscopic scraping was 73.53%(50/68), and non-conformity was 26.47%(18/68), of which were over-diagnosed 5.88%(4/68), under-diagnosed 20.59%(14/68). colposcopy examination and neck lining scrape intraoperative and postoperative pathology of CIN Ⅰ, CIN Ⅱ, CIN Ⅲ and invasive cancer diagnosis is no statistical difference (P>0.05). Conclusion: Colposcopic examination and endocervical curettage are important means to prevent and treat cervical cancer, which can increase the accuracy of pathological biopsy to a certain extent and provide reliable basis for clinical treatment.