三阶梯诊疗程序筛查诊治宫颈癌前病变的临床分析

Clinical analysis of three-step screening procedure in the diagnosis and treatment of cervical precancerous lesions

目的对宫颈癌前病变应用三阶梯诊疗程序筛查的效果进行观察.方法选取2018年1月至2018年12月本院经宫颈细胞学检查异常的患者50例作为研究对象,所有患者均行宫颈细胞学检查、阴道镜检查、组织病理学检查三阶梯诊疗程序,对检查结果进行统计观察.结果50例宫颈细胞学检查结果异常患者中,ASC、LSIL、HSIL、SCC检出率分别为64.00%、26.00%、8.00%、2.00%;采用阴道镜并宫颈多点活检组织病理血检查中,29例异常,符合率58.00%;采用宫颈多点活检组织病理学检查,32例异常,符合率64.00%.20例LSIL患者中,18例为CINⅠ,诊断符合率90.00%;8例HSIL患者中,6例为CINⅡ,2例为CINⅢ,诊断符合率为100.00%;1例宫颈癌患者经病理诊断确诊,诊断符合率为100.00%;组织病理学检查结果显示,炎症17例、CINⅠ22例、CINⅡ8例、CINⅢ2例、宫颈癌1例,诊断符合率为66.00%.ASC中,CIN患者17例,诊断符合率53.13%;LSIL中,CIN患者12例,诊断符合率92.31%;HSIL中,CINⅡ患者1例,无CINⅢ患者,诊断符合率为25.00%;SCC患者1例,诊断符合率100.00%.结论三阶梯诊疗程序在宫颈癌前病变筛查中应用,对宫颈细胞学检查异常者,依次采用阴道镜检查与组织病理学检查,能对宫颈癌前病变尽早发现,及时干预,降低CIN发展为浸润性宫颈癌的机会.

Objective To observe the effect of screening cervical precancerous lesions with three-step diagnostic and therapeutic procedures.Methods 50 patients with abnormal cervical cytology in our hospital from January 2018 to December 2018 were selected as subjects. All patients underwent cervical cytology, colposcopy and histopathological examination. The results were statistically observed. Results Among 50 patients with abnormal results of cervical cytology, the detection rates of ASC, LSIL, HSIL and SCC were 64.00%, 26.00%, 8.00% and 2.00% respectively.29 patients with abnormal results were examined by colposcopy and cervical multipoint biopsy, and the coincidence rate was 58.00%. 32 patients with abnormal results were examined by cervical multipoint biopsy, and the coincidence rate was 64.00%. Among 20 LSIL patients, 18 cases were CINⅠ, the diagnostic coincidence rate was 90.00%. 8 HSIL patients, 6 cases were CINⅡ, 2 cases were CINⅢ, the diagnostic coincidence rate was100%. One case of cervical cancer was diagnosed by pathological diagnosis and the diagnostic coincidence rate was 100.00%. Histopathological examination showed that 17 cases were inflammation, 22 cases were CINⅠ, 8 cases were CINⅡ, 2 cases were cervical cancer, and the diagnostic coincidence rate was 66.00%. In ASC, 17 cases were CIN patients, the diagnostic coincidence rate was 53.13%. In LSIL, 12 cases were CIN patients, the diagnostic coincidence rate was 92.31%. In HSIL, 1 case was CINⅡ patients, and no CINⅢ patients, the diagnostic coincidence rate was 25.00%;in SCC, the diagnostic coincidence rate was 100.00%. Conclusion The application of three-step procedure in screening of cervical precancerous lesions, colposcopy and histopathological examination are adopted in turn for those with abnormal cervical cytological examination, which can detect cervical precancerous lesions as early as possible, intervene in time and reduce the chance of CIN developing into invasive cervical cancer.