液基薄层细胞学检查、阴道镜下活检与宫颈环形电切术在诊治宫颈上皮内瘤变中的价值

摘要

目的：探讨液基薄层细胞学检查( thin prep cytology test, TCT )、阴道镜下活检和宫颈环形电切术( loop electrosurgical excision procedure ,LEEP)在诊治宫颈上皮内瘤变( cervical intraepithelial neoplasia,CIN)的价值。方法选取2014年1月至2016年5月在钟祥市人民医院妇产科治疗的CIN患者274例,比较TCT、阴道镜下活检和LEEP活检的结果。结果 TCT检查与阴道镜下活检诊断符合率为65．33%(179/274),诊断Kappa值为0．412(P<0．05)；TCT检查与LEEP活检诊断符合率为75．55%(207/274),诊断Kappa值为0．558(P<0．05)；阴道镜下活检与 LEEP活检诊断符合率为55．84%(153/274),诊断Kappa值为0．271(P<0．05)。结论 TCT检查是目前辅助诊断CIN的有效方法,阴道镜下活检无法完全替代LEEP活检,LEEP是一种有效的诊断及治疗CIN的方法。%Objective To investigate the value of thin prep cytology test ( TCT ) , colposcopic biopsy and loop electrosurgical excision procedure ( LEEP) in the diagnosis and treatment of cervical intraepithelial neoplasia ( CIN) . Methods Compare the TCT, colposcopic biopsy and LEEP biopsy results of 274 patients with CIN who were treated in Department of Obstetrics and Gynecology, Zhongxiang People's Hospital from January 2014 to May 2016. Results TCT and colposcopic biopsy diagnostic coincidence rate was 65. 33% (179/274), the Kappa value was 0. 412 (P<0. 05);TCT and LEEP biopsy diagnostic coincidence rate was 75. 55% (207/274), the Kappa value was 0. 558(P<0. 05);Colposcopic biopsy and LEEP biopsy diagnostic coincidence rate was 55. 84% (153/274), the Kappa value was 0. 271 (P<0. 05). Conclusion TCT is an effective way to help with the diagnosis of CIN. Colposcopic biopsy can not completely replace the LEEP biopsy. LEEP is an effective method for the diagnosis and treatment of CIN.