探讨宫颈脱落细胞学检查高级别异常结果在阴道镜拟诊中的临床价值

Discussion on the clinical value of high-grade abnormal results of cervical exfoliated cytology in colposcopy diagnosis

目的分析宫颈脱落细胞学检查高级别异常结果在阴道镜拟诊中的应用效果。方法168例宫颈脱落细胞学检查(TCT)诊断结果为非典型鳞状细胞倾向于高度病变(ASC-H)和以上患者,以其组织病理学结果为金标准,比较阴道镜联合TCT高级别异常检查与阴道镜的诊断结果;阴道镜联合TCT高级别异常与单独TCT对宫颈上皮内瘤变(CIN)2阳性的检出率。结果阴道镜联合TCT高级别异常检查对CIN2、CIN3、子宫颈癌、原位腺癌的阳性检出率分别为98.33%、95.00%、100.00%、100.00%,均高于单独阴道镜的88.33%、65.00%、66.67%、25.00%,差异具有统计学意义(P<0.05)。阴道镜联合TCT高级别异常检查对CIN2阳性检出率高于TCT,差异有统计学意义(P<0.05)。结论在阴道镜拟诊中,TCT高级别异常结果的应用能够有效提升高级别异常诊断效果,可以为患者后续治疗提供重要依据,具有推广价值。

Objective To analyze the practical effect of high-grade abnormal results of cervical exfoliated cytology in colposcopy diagnosis.Methods There were 168 patients with unexplained atypical squamous cells,cannot exclude high-grade squamous intraepithelial lesion(ASC-H)and above diagnosed by thinprep cytology test(TCT).Using histopathological results as the gold standard,comparison was made on diagnosis results of colposcopy combined with TCT high-grade abnormalities and colposcopy,and the detection rate of cervical intraepithelial neoplasia(CIN)2 positive by colposcopy combined with TCT high-grade abnormalities and TCT alone.Results Histopathological diagnosis results:43 cases of CIN 2 were diagnosed in 168 patients,including 5 cases of chronic cervicitis,15 cases of HSIL/CIN2,10 cases of HSIL/CIN3,and 4 cases of low-grade squamous intraepithelial lesion(LSIL),5 cases of cervical cancer,and 4 cases of adenocarcinoma in situ.The detection rates of HSIL for chronic cervicitis,HSIL/CIN2,HSIL/CIN3,LSIL,cervical cancer and adenocarcinoma in situ by colposcopy combined with TCT high-grade abnormal examination were 100.00%,93.33%,90.00%,100.00%,100.00%and 100.00%respectively,which were higher than 40.00%,60.00%,40.00%,25.00%,40.00%and 25.00%by colposcopy alone,and the difference was statistically significant(P<0.05).The detection rate of CIN2 positive high-grade abnormalities by colposcopy combined with TCT high-grade abnormality examination was higher than that of TCT alone,and the difference was statistically significant(P<0.05).Conclusion In colposcopic diagnosis,the application of high-grade abnormal results of cervical exfoliative cytology can effectively improve the effect of high-grade abnormal diagnosis,and it can provide important basis for the follow-up treatment of patients,which has promotional value.