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目的:探讨不典型鳞状上皮细胞(ASC)在宫颈病变中的临床意义及阴道镜检查对ASC再分类的价值,为临床提供指导和管理依据。方法:对412例细胞学结果为ASC的患者全部进行阴道镜检查及定位活检,以病理学诊断为金标准,计算宫颈病变率及阴道镜拟诊的符合率。结果:ASC中包含了各级宫颈病变,其中CINⅠ为29.6%(122/412),CINⅡ为4.6%(19/412),CINⅢ为1.7%(7/412)。阴道镜诊断和病理学结果有较高一致性,Kappa=0.7(P<0.001)。阴道镜对宫颈病变诊断的敏感度为90.2%(148/164),阴性预测值达92.9%(209/225)。结论:ASC中仍有较高的宫颈病变发生率,阴道镜检查对宫颈病变诊断有较高的预测价值。
Objective: To investigate the clinical significance of atypical squamous cell (ASC) in cervical lesions and the value of colposcopy in reclassifying ASC, so as to provide guidance and management basis for clinical practice. Methods: A total of 412 patients with ASC cytology were examined by colposcopy and biopsy. The pathological diagnosis was the gold standard, and the coincidence rate of cervical lesions and colposcopy was calculated. Results: Cervical lesions at various stages were included in ASC, including 29.6% (122/412) in CINⅠ, 4.6% (19/412) in CINⅡ and 1.7% (7/412) in CINⅢ. Colposcopy diagnosis and pathology results were highly consistent, Kappa = 0.7 (P <0.001). The sensitivity of colposcopy in the diagnosis of cervical lesions was 90.2% (148/164), and the negative predictive value was 92.9% (209/225). Conclusion: There is still a high incidence of cervical lesions in ASC. Colposcopy has a higher predictive value for the diagnosis of cervical lesions.