宫颈癌筛查中阴道镜检查阳性与宫颈病理诊断关系的探讨

Investigation of the relationship between cervical pathological diagnosis and colposcopy was positive in the screening of cervical cancer

目的:探讨阴道镜阳性在宫颈上皮内瘤变(CIN)诊断中的意义,评价阴道镜图像阳性对CIN的诊断价值。方法:2013年9-12月对贵州省遵义县35~64岁农村妇女行宫颈癌筛查1.5万人,TCT异常者,即检出ASC-US者行阴道镜检查,共200例患者行阴道镜检查,阴道镜检查图像异常130例,以予宫颈活检病理学诊断结果为标准,对阴道镜阳性与病理结果进行分析。结果:电子阴道镜在CIN诊断中敏感性99.01%,特异性90.90%,阳性预测值90.65%,假阴性率2.78%,假阳性率9.09%。单一醋白上皮出现率最高81.75%,从宫颈炎到CIN所有类型中,均有扁平醋白,在高级别CIN中均见到致密厚实醋白上皮;CIN中出现二联征80.00%,CINⅢ中见到三联征和醋白上皮+非典型血管,检测率分别是100%和80.00%。结论:阴道镜是辅助诊断CIN的有效方法,典型的异常阴道镜图像对诊断CIN和宫颈癌有重要价值。

Objective:To investigate the significance of colposcopy positive in cervical intraepithelial neoplasia(CIN),to evaluate the value of colposcopy positive image in the diagnosis of CIN.Methods:We took cervical cancer screening in 15 000 cases of 35~64 years old rural women in Zunyi County of Guizhou province from September to December in 2013.We took colposcopy examination for the TCT was abnormal(ASC-US) patients;200 patients underwent colposcopy examination,the colposcopy image abnormality in 130 cases,pathological diagnosis of cervical biopsy results as the standard.We analyzed the colposcopy of positive and pathological results.Results:The sensitivity of electronic colposcopy in the diagnosis of CIN was 99.01%;specificity of 90.90%;positive predictive value of 90.65%;false negative rate was 2.78%,and false positive rate was 9.09%.The single white vinegar epithelium was the highest rate of 81.75%,to all types of CIN from cervicitis,have a flat white vinegar,and we can see the dense thick white vinegar epithelium at high level CIN;two joint syndrome 80% occurred in CIN,and we can see the triad and intraepithelial white vinegar+atypical vascular in CIN Ⅲ,the detection rate is 100% and 80% respectively.Conclusion:Colposcopy is an effective method for diagnosis of CIN.The abnormal colposcopy image typically has important value for the diagnosis of CIN and cervical cancer.