阴道镜联合HPV检查对宫颈癌及宫颈鳞状上皮内病变的诊断价值

The diagnostic value of colposcopy combined with HPV examination for cervical cancer and cervical squamous intraepithelial lesions

目的分析宫颈癌及宫颈鳞状上皮内病变特点,评价阴道镜联合人乳头瘤病毒(HPV)检查的价值。方法81例参与两癌筛查项目的宫颈初筛异常转诊阴道镜患者,其中,60例患者行阴道镜联合HPV检查,21例患者只接受阴道镜检查。统计阴道镜检查和阴道镜联合HPV检查的检出情况及检出患者的宫颈活检病理检查结果,以宫颈活检的病理诊断为标准,比较阴道镜检查和阴道镜联合HPV检查对宫颈癌及宫颈鳞状上皮内病变的阳性检出率。结果81例参与两癌筛查项目的宫颈初筛异常转诊阴道镜患者中,检出49例,经宫颈活检病理显示炎症19例、低级别病变18例、高级别病变12例以及宫颈癌1例,宫颈癌及宫颈鳞状上皮内病变的阳性检出率为63.27%(31/49)。60例经阴道镜联合HPV检查的患者中,检出38例,经宫颈活检病理显示炎症12例、低级别病变15例、高级别病变11例以及宫颈癌1例,宫颈癌及宫颈鳞状上皮内病变的阳性检出率为71.05%(27/38)。21例阴道镜检查的患者中,检出11例,经宫颈活检病理显示炎症7例、低级别病变3例、高级别病变1例以及宫颈癌0例,宫颈癌及宫颈鳞状上皮内病变的阳性检出率为36.36%(4/11)。阴道镜对宫颈癌及宫颈鳞状上皮内病变的阳性检出率明显低于阴道镜联合HPV检查的,差异具有统计学意义(P<0.05)。结论阴道镜联合HPV检查助于诊断宫颈癌及宫颈上皮内病变,具有较高的准确率,为女性疾病早期治疗提供参考。

Objective To analyze the characteristics of cervical cancer and cervical squamous intraepithelial lesions,and evaluate the value of colposcopy combined with human papilloma virus(HPV).Methods Among 81 patients with abnormal cervical screening who participated in the two-cancer screening programs,60 patients received colposcopy combined with HPV examination,and 21 patients only received colposcopy examination.The detection of colposcopy and colposcopy combined with HPV examination,and the pathological results of cervical biopsy were collected.Taking the pathological diagnosis of cervical biopsy as the standard,the positive detection rate of cervical cancer and cervical squamous intraepithelial lesions was compared between colposcopy and colposcopy combined with HPV examination was compared.Results Among the 81 patients who were involved in the two-cancer screening programs,49 cases were detected,including 19 cases of inflammation,18 cases of low-grade lesions,12 cases of high-grade lesions and 1 case of cervical cancer.The positive detection rate of cervical cancer and cervical squamous intraepithelial lesions was 63.27%(31/49).Among the 60 cases examined by colposcopy combined with HPV,38 cases were detected.Cervical biopsy showed 12 cases of inflammation,15 cases of low-grade lesions,11 cases of high-grade lesions and 1 case of cervical cancer.The positive detection rate of cervical cancer and cervical squamous intraepithelial lesions was 71.05%(27/38).Among 21 cases examined by colposcopy,11 cases were detected.Cervical biopsy showed 7 cases of inflammation,3 cases of low-grade lesions,1 case of high-grade lesions and 0 case of cervical cancer.The positive detection rate of cervical cancer and cervical squamous intraepithelial lesions was 36.36%(4/11).The positive detection rate of colposcopy for cervical cancer and cervical squamous intraepithelial lesions was significantly lower than that of colposcopy combined with HPV examination,and the difference was statistically significant(P<0.05).Conclusion Combined examination of colposcopy and HPV is helpful for the diagnosis of cervical cancer and cervical intraepithelial lesions.It has a high accuracy rate,and can provide a reference for early treatment of female diseases.