阴道镜下活检加颈管搔刮与宫颈电圈切除术对诊断宫颈上皮内瘤变的临床观察比较

Comparison of clinical observation of biopsy under colposcopy plus the cervical canal curettage and loop electrosurgical excision procedure in the diagnosis of cervical intraepithelial neoplasia

目的:探讨阴道镜下活检加颈管搔刮与宫颈电圈切除术对诊断宫颈上皮内瘤变的临床价值。方法:2013年1月-2014年8月收治行宫颈环形电切术(LEEP)治疗患者320例,本组所有患者在行LEEP治疗前均进行阴道镜下活检加颈管搔刮检查。结果:阴道镜下活检及颈管搔刮诊断为慢性宫颈炎209例,LEEP术后病理慢性宫颈炎诊断283例,诊断符合率73.8%;阴道镜下活检及颈管搔刮诊断为宫颈息肉25例,LEEP术后病理诊断宫颈息肉26例,诊断符合率96.2%;阴道镜下活检及颈管搔刮诊断宫颈湿疣15例,误诊7例;诊断CINⅠ133例,误诊77例;诊断CINⅠ~Ⅱ13例,误诊2例;诊断CINⅡ70例,诊断符合率94.6%;诊断CINⅡ~Ⅲ5例,诊断符合率41.7%。结论:阴道镜下活检加颈管搔刮诊断宫颈上皮内瘤变准确率较高,但也有一定的局限性。

Objective:To explore the clinical value of biopsy under colposcopy plus the cervical canal curettage and loop electrosurgical excision procedure in the diagnosis of cervical intraepithelial neoplasia.Methods:320 patients treated with LEEP were selected from January 2013 to August 2014.Before LEEP treatment,all patients were given biopsy under colposcopy and cervical canal curettage check.Results:Diagnosis of 209 cases with biopsy under colposcopy and cervical canal curettage was chronic cervicitis,diagnosis of 283 cases with pathology after LEEP operation was chronic cervicitis,the diagnostic accordance rate was 73.8%;diagnosis of 25 cases with biopsy under colposcopy and cervical canal curettage was cervical polyp,diagnosis of 26 cases with pathology after LEEP operation was cervical polyp,the diagnostic accordance rate was 96.2%;diagnosis of 15 cases with biopsy under colposcopy and cervical canal curettage was cervical condyloma,7 cases were misdiagnosis;diagnosis of 133 cases was CIN Ⅰ,77 cases were misdiagnosis;diagnosis of CIN Ⅰ to Ⅱ was in 13 patients,2 cases were misdiagnosis;diagnosis of CIN Ⅱ was in 70 patients,the diagnostic accordance rate was 94.6% ;the diagnosis of 5 cases was CIN Ⅱ to Ⅲ,diagnostic accordance rate was 41.7% .Conclusion:The accurate rate of biopsy under colposcopy plus the cervical canal curettage in the diagnosis of cervical intraepithelial neoplasia was higher,but there were some limitations.