联合筛查对CIN患者的诊治价值研究

Study of Diagnostic and Therapeutic Value of Combined Screening in Patients with Cervical Intraepithelial Neoplasia

目的探讨液基薄层细胞学检测(TCT)联合电子阴道镜及环形电切除术(LEEP)治疗在宫颈上皮内瘤变(CIN)患者中的临床应用价值。方法选取1 397例行TCT检查的已婚女性纳入研究,其中检查呈阳性者113例,行阴道镜下多点活检并进行病理学检查。检查确诊为宫颈上皮内瘤变患者行LEEP治疗。结果进行临床和病理学分析比较。结果 TCT检测病例数1 397例,其中检出阳性涂片113例(8.1%):其中ASCUS+AGUS 74例(65.5%),ASC-H 4例(3.5%),LSIL 23例(20.4%),HSLL 8例(7.1%),癌4例(3.5%);所有患者均在阴道镜下多点采样行病理检查,异常阴道镜图象91例(80.5%),其中炎症33例(29.2%),CINⅠ40例(35.4%),CINⅡ13例(11.5%),CINⅢ4例(3.5%),癌1例(0.9%)。LEEP手术治疗后切下的标本进行病理结果分析,其中炎症8例(14%),CINⅠ34例(59.6%),CINⅡ11例(19.3%),CINⅢ3例(5.2%),浸润癌1例(1.9%)。结论 TCT、阴道镜下多点活检联合LEEP术可以使宫颈上皮细胞内瘤变患者得到准确的诊断和及时的治疗。

Objective To explore the clinical value of thin-layer cytological test system ( TCT) ,loop electrosurgical ex-cision procedure (LEEP),and colposcopic biopsy in the treatment of cervical intraepithelial noeplasia (CIN).Methods 1 397 female patients were examined by TCT .113 patients with positive results received colposcopic biopsy and pathological examina-tion.Patients diagnosed as CIN received LEEP .The results were compared between clinical and pathological analysis .Results Among 1 397 patients,113 patients were cytologically diagnosed as positive ,including 74 cases of ASCUS+AGUS (65.5%),4 cases of ASC-H (3.5%),23 cases of LSIL (20.4%),8 cases of HSIL (7.1%),and 4 cases of cancer (3.5%).All patients received pathological examination under colposcopic biopsy .There were 91 cases with abnormal colposcopic images (80.5%),in-cluding 33 cases of inflammation (29.2%),40 cases of CINⅠ(35.4%),13 cases of CINⅡ(11.5%),4 cases of CINⅢ(3.5%),and 1 case of cancer (0.9%).The pathological results of the specimen resected through LEEP indicated that there were 8 cases of inflammation (14.0%),34 cases of CINⅠ(59.6%),11 cases of CINⅡ(19.3%),3 cases of CIN Ⅲ(5.2%), and 1 case of infiltrative cancer (1.9%).Conclusion The combination of the TCT,LEEP,and colposcopic biopsy contribute to the accurate diagnosis and timely treatment of patients with CIN .