阴道镜检查在宫颈上皮内瘤变及宫颈癌诊断中的应用价值

摘要

Objective: To explore the value of colposcopy in the diagnosis of cervical diseases.rnMethods; A total of 5,833 patients were examined with Thinprep Cytologic Test(TCT) in the Third Hospital of Datong Colliery Corporation, Shanxi Province from Jul. 2006 to Oct. 2010. Two hundred and sixty-three patients with TCT positive were selected to do the electronic colposcopy test and the pathological examination of biopsy at the same time.rnResults: Among two hundred and sixty-three patients with TCT positive and cervical lesions, there were 37 cases of chronic cervicitis; 181 cases of cervical intraepithelial neoplasia (CIN) including 93 cases of CINⅠ, 50 cases of CINⅡ and 38 cases of CINⅢ; and 45 cases of cervical cancer according to colposcopy examination diagnosis. There were 36 cases of chronic cervicitis; 180 cases of CIN including 97 cases of CINⅠ, 46 cases of CINⅡ and 37 cases of CINⅢ; and 47 cases of cervical cancer according to the pathological examination results. Colposcopy examination in the diagnosis of CIN and cervical cancer showed that sensitivity was 97. 8%, specificity 94. 4%, accuracy 92. 2%, positive predictive 99. 1% and negative predictive 91. 9%. For patients with cervical cancer and CIN, the diagnostic accordance rate with colposcopy and pathological examination was more than 90%. Conclusions: Colposcopy has the great value in early diagnosis and treatment of cervical precancerous lesions, reducing the cervical cancer incidence.%目的 探讨阴道镜检查在宫颈疾病诊断中的应用价值. 方法 对2006年7月至2010年10月我院5,833例进行阴道脱落细胞液基薄层细胞学检查(TCT)呈阳性的患者263例行电子阴道镜检查,并在阴道镜下行定点多点宫颈活组织病理学检查. 结果 263例TCT阳性宫颈病变患者中,阴道镜检查诊断结果为慢性宫颈炎37例；宫颈上皮内瘤变(CIN)181例,其中CIN Ⅰ 93例,CIN Ⅱ 50例,CIN Ⅲ 38例；宫颈癌45例.经宫颈活组织病理学检查诊断结果为慢性宫颈炎36例；CIN 180例,其中CINⅠ 97例,CIN Ⅱ 46例,CIN Ⅲ 37例；宫颈癌47例.阴道镜检查对诊断宫颈CIN及宫颈癌的价值显示灵敏度97.8％,特异度94.4％,准确度92.2％,阳性预测值99.1％,阴性预测值91.9％.对于宫颈CIN和宫颈癌患者,阴道镜检查结果和病理检查结果的诊断符合率均高于90％. 结论 阴道镜检查对宫颈癌前病变的早期诊断、早期治疗具有重要的价值,对降低宫颈癌的发生率有一定的应用价值.