阴道镜下宫颈活检在宫颈癌前病变诊断中的应用及诊断效能

Application and Diagnostic Efficacy of Cervical Biopsy Under Colposcopy in the Diagnosis of Cervical Precancerous Lesions

目的针对宫颈筛查异常患者开展阴道镜下宫颈活检的临床诊断效果进行分析。方法2023年1月至2023年12月在本院开展国家免费宫颈癌筛查的妇女中共检测8524人,高危型阳性1339人,并对高危型阳性妇女进一步开展液基细胞学检查(TCT),针对TCT异常患者开展阴道镜宫颈活检共计460例,其中有异常434例,最终经过病理学诊断,宫颈癌前病变197例、宫颈微小浸润癌3例、宫颈浸润癌5例。以病理学诊断为金标准,综合对比TCT检查、阴道镜下宫颈活检在宫颈癌前病变诊断中的效能。结果阴道镜宫颈活检在诊断准确率、灵敏度、特异性方面与金标准对比,差异无统计学意义(P>0.05)。阴道镜宫颈活检诊断准确率、特异性高于TCT诊断、误诊率低于TCT检查,(P<0.05)。结论针对宫颈筛查异常患者开展阴道镜下宫颈活检具备较高准确率,有助于促使患者迅速得到确诊,提升对宫颈癌前病变患者的诊断效能。

Objective To analyze the clinical diagnostic effect of cervical biopsy under colposcopy for patients with abnormal cervical screening.Methods From January 2023 to December 2023,a total of 8524 women were tested for free national cervical cancer screening in our hospital,and 1339 were positive for high-risk types.Liquid based cytological examination(TCT)was further carried out on high-risk positive women.A total of 460 colposcopic cervical biopsies were carried out on patients with abnormal TCT,of which 434 were abnormal.Finally,pathological diagnosis showed 197 cases of cervical precancerous lesions,3 cases of cervical microinvasive carcinoma,and 5 cases of cervical invasive carcinoma.Taking pathological diagnosis as the gold standard,the efficacy of TCT examination and colposcopic cervical biopsy in the diagnosis of cervical precancerous lesions was compared.Results There was no statistically significant difference(P>0.05)in diagnostic accuracy,sensitivity,and specificity between colposcopy cervical biopsy and the gold standard.The diagnostic accuracy and specificity of vaginal colposcopy cervical biopsy are higher than those of TCT diagnosis,and the misdiagnosis rate is lower than that of TCT examination(P<0.05).Conclusions Conducting vaginal colposcopy cervical biopsy for patients with abnormal cervical screening has a high accuracy rate,which helps to promote rapid diagnosis and improve the diagnostic efficiency for patients with cervical precancerous lesions.