阴道镜下定位活检方案对宫颈鳞状上皮内病变进行诊断的临床应用价值分析

The clinical value of localized biopsy with colposcopy for the diagnosis of cervical squamous intraepithelial lesions

目的探讨并分析阴道镜下定位活检方案对于宫颈鳞状上皮内病变进行诊断的临床应用价值。方法将2018年11月~2019年4月我院收治的387例阴道镜下定位活检患者作为研究对象。采用简单随机抽样将结果根据WHO女性生殖器肿瘤分类(2014)建议采用与细胞学分类相同的二级分类法(即LSIL和HSIL),将患者分为低级别鳞状上皮内病变(LSIL)、高级别鳞状上皮内病变(HSIL)、慢性宫颈炎共三组。对相应的患者进行病理检查,对病情进行分析确诊,并研究其相应的临床价值。结果经检查,慢性宫颈炎占44.19%,宫颈鳞状上皮内病变(SIL)占55.81%,其中LSIL 156例、HSIL 60例。醋酸白色上皮、点状血管、镶嵌等为患者阴道镜的异常图像表现。SIL病变级别与阴道镜图像的合并病变严重程度成正比,且出现阴道镜下2级病变的几率越大,HSIL组显著高于LSIL组,LSIL组显著高于慢性宫颈炎组,差异均有统计学意义(P<0.05)。结论阴道镜下定位活检对于宫颈鳞状上皮内病变患者具有重要的应用诊断价值,可作为宫颈鳞状上皮内病变的重要判断手段,具有良好的临床应用价值。

Objective To explore and analyze the clinical value of localized biopsy with colposcopy in the diagnosis of cervical squamous intraepithelial lesions.Methods 387 patients underwent localized biopsy with colposcopy in our hospital from November 2018 to April 2019 were selected as subjects.According to the WHO classification of female genital tumors(2014),patients were divided into three groups using random sampling method and secondary classification method as cytologic classification:low-level squamous intraepithelial lesions(LSIL),highlevel squamous intraepithelial lesions(HSIL)and chronic cervicitis.Corresponding patients were given pathology examination to diagnose the disease and explore its corresponding clinical value.Results After examination,chronic cervicitis accounted for 44.19%,cervical squamous intraepithelial lesions(SIL)accounted for 55.81%,including 156 cases of LSIL and 60 cases of HSIL.Aceto-white epithelium,punctate blood vessels and inlay were the abnormal images of colposcopy.The level of SIL lesion was proportional to the severity of the combined lesions in colposcopy images,and the incidence of grade 2 lesions under colposcopy.SIL lesion in the HSIL group was higher than that in the LSIL group,and the LSIL group was higher than that in the chronic cervicitis group,and the differences were statistically significant(P<0.05).Conclusion Localized biopsy with colposcopy is of great value in the diagnosis of cervical SIL,and it can be used as an important means to identify cervical SIL,and has good clinical value.