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目的探讨宫颈脱落细胞液基薄层细胞学检查(TCT)和阴道镜检查在诊断宫颈癌及癌前病变中的作用。方法 2010年9月至2011年8月在我院门诊行TCT检查的患者3047例,对TCT结果阳性的患者行阴道镜检查,镜下取活检。结果 TCT对CINⅠ、CINⅡ-CINⅢ(包括原位癌)及宫颈癌的敏感度分别为78.7%、74.8%、86.4%,特异度为84.1%、92.3%,98.7%。阴道镜检查对CINⅠ、CINⅡ-CINⅢ(包括原位癌)及宫颈癌诊断的敏感度为75.2%、73.2%、68.2%,特异度为83.6%、86.4%及99.3%。在诊断CINⅠ时,两种方法无统计学差异(χ2=0.065,P>0.05),而在诊断CINⅡ-CINⅢ和宫颈癌时两种方法差异具有统计学意义(χ2=4.01,P<0.05)。结论 TCT和联合阴道镜检查提高宫颈癌及癌前病变的诊断率。
Objective To investigate the role of cervical cytology (TLCT) and colposcopy in the diagnosis of cervical cancer and precancerous lesions. Methods From September 2010 to August 2011, 3047 patients with TCT in outpatient department of our hospital underwent colposcopy and biopsy under the microscope. Results The sensitivity of TCT to CINⅠ, CINⅡ-CINⅢ (including carcinoma in situ) and cervical cancer were 78.7%, 74.8%, 86.4%, and specificity were 84.1%, 92.3%, 98.7% respectively. The sensitivity of colposcopy in diagnosis of CINⅠ, CINⅡ-CINⅢ (including carcinoma in situ) and cervical cancer was 75.2%, 73.2%, 68.2%, and the specificity was 83.6%, 86.4% and 99.3% respectively. There was no significant difference between the two methods in the diagnosis of CIN Ⅰ (χ2 = 0.065, P> 0.05). However, there was a significant difference between the two methods in diagnosing CINⅡ-CINⅢ and cervical cancer (χ2 = 4.01, P <0.05). Conclusion TCT and colposcopy improve the diagnosis rate of cervical cancer and precancerous lesions.