宫颈癌病理活检与术后病理石蜡切片的符合率分析

An analysis of the coincidence and significance of cervical carcinoma biopsy pathology and paraffin section pathology after surgery

随机选取宁德市某医院收治的187例宫颈癌患者作为研究对象,行手术治疗,术前行阴道镜下宫颈病理活检诊断,术后行病理石蜡切片诊断,研究分析两种诊断方式的符合率.结果显示,宫颈癌病理活检与术后病理石蜡切片诊断的符合率为80.75%;宫颈鳞癌、腺癌、腺鳞癌和其他少见病理类型的术后病理石蜡切片诊断与术前病理活检诊断符合率分别为81.01%、72.34%、46.15%和68.18%;原位癌-Ia1期宫颈癌病理活检符合率为59.21%(45/76),Ia2期-Ⅱb期符合率为80.18%(89/111),差异具有统计学意义(P<0.05).研究表明,在宫颈癌诊断过程中,鳞腺癌病理活检与病理石蜡切片检查符合率较低,且原位癌-Ia1期宫颈癌病理活检符合率不理想,说明术前阴道镜下宫颈病理活检诊断存在漏检可能性.建议尽量开展有效的病理会诊,以便为后续治疗提供临床依据.

187 patients with cervical cancer in a hospital of Ningde City were randomly selected for surgical treatment.The cervical pathological biopsy under colposcopy before operation and pathological paraffin section after operation were performed for diagnosis.The coincidence rate and significance of the two diagnostic methods were studied and analyzed.The results showed that the coincidence rate between pathological biopsy diagnosis and postoperative pathological paraffin section diagnosis of cervical cancer was 80.75%.The coincidence rates of diagnostic methods in cervical squamous cell carcinoma,cervical adenocarcinoma,cervical adenosquamous cell carcinoma and other rare pathological types were 81.01%,72.34%,46.15%and 68.18%,respectively.The coincidence rates of diagnostic methods in cervical cancer in situ to stage-Ia1 was 59.21%(45 to 76),and that of stageIa2 to stage-Ⅱb was 80.18%(89 to 111).The difference was statistically significant(P<0.05).Studies have shown that in the process of diagnosis of cervical cancer,the coincidence rates of diagnostic methods in cervical adenosquamous cell carcinoma were low,and that of in situ-Ia1 stage was also not ideal,indicating the possibility of missed diagnosis of cervical pathological biopsy under colposcopy before operation.It was suggested that effective pathological consultation should be carried out as far as possible in order to provide clinical evidence for follow-up treatments.