宫颈癌活检病理与术后石蜡病理两种诊断方法的价值

Value of Two Diagnostic Methods of Cervical Cancer Biopsy Pathology and Postoperative Paraffin Pathology

目的研究宫颈癌活检病理与术后石蜡病理两种诊断方法的价值。方法选取2020年12月-2023年6月我院诊治的269例疑似宫颈癌患者为研究对象,术前均进行宫颈病理活检诊断,术后进行病理石蜡切片诊断,观察两种诊断方法检测结果、不同病理类型诊断符合率、不同病理分期诊断符合率以及诊断效能(灵敏度、特异度、准确率)。结果术后石蜡病理诊断不同病理类型宫颈疾病例数与阴道镜下宫颈活检病理检查比较,差异有统计学意义(P<0.05);不同病理类型阴道镜下宫颈活检病理检查诊断符合率比较,差异有统计学意义(P<0.05);Ⅰa2期~Ⅱb期阴道镜下宫颈活检病理诊断符合率为66.67%,高于原位癌~Ⅰa1期的60.00%(P<0.05);与术后石蜡病理诊断结果比较,宫颈癌活检病理灵敏度、特异度、准确率均较低。结论宫颈癌术后石蜡病理诊断价值更高,术前阴道镜下宫颈病理活检虽然利于高级别鳞状上皮内病变、原位癌~Ⅰa1期宫颈癌的检出,但是诊断存在漏检可能性,临床应尽量开展有效的病理会诊,为后续治疗提供合理依据。

Objective To study the value of two diagnostic methods of cervical cancer biopsy and postoperative paraffin pathology.Methods A total of 269 patients with suspected cervical cancer diagnosed and treated in our hospital from December 2020 to June 2023 were selected as the research objects.Cervical pathological biopsy was performed before operation,and pathological paraffin section diagnosis was performed after operation.The detection results of the two diagnostic methods,the diagnostic coincidence rate of different pathological types,the diagnostic coincidence rate of different pathological stages and the diagnostic efficiency(sensitivity,specificity and accuracy)were observed.Results The number of cases of different pathological types of cervical diseases diagnosed by postoperative paraffin pathology was significantly different from that of cervical biopsy under colposcopy(P<0.05).There were significant differences in the coincidence rate of pathological examination of cervical biopsy among different pathological types(P<0.05).The coincidence rate of pathological diagnosis of cervical biopsy under colposcopy in stageⅠa2-Ⅱb was 66.67%,which was higher than 60.00%in carcinoma in situ-stageⅠa1(P<0.05).Compared with the results of postoperative paraffin pathological diagnosis,the sensitivity,specificity and accuracy of cervical cancer biopsy were lower.Conclusion The value of paraffin pathological diagnosis after cervical cancer surgery is higher.Although preoperative cervical pathological biopsy under colposcopy is conducive to the detection of high-grade intraepithelial neoplasia and carcinoma in carcinoma in situ-stageⅠa1 cervical cancer,there is a possibility of missed diagnosis.Effective pathological consultation should be carried out as far as possible to provide a reasonable basis for subsequent treatment.