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目的探讨阴道镜检查结合活组织检查对于宫颈癌及其宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的意义。方法随机选取自2000年至今在我院妇产科门诊就诊的门诊患者750例,在检查前未经任何宫颈药物或物理治疗,无阴道炎症,排除其他器官系统性疾病的患者,进行阴道镜检查,同时行宫颈5%醋酸涂抹,并于病变区尤其宫颈鳞柱状上皮交界处及异常病变处进行多点活检,其中170例患者经同意后同时进行宫颈液基细胞学(LPT)检查。结果在检测的750例的病理结果中,炎性改变487例,占63.62%,CIN Ⅰ级153例,占21.16%,CIN Ⅱ级68例,占9.42%,CIN Ⅲ级21例,占2.90%。宫颈癌21例,占2.90%。宫颈液基细胞学检查(LPT)与病理总符合率为38.82%,阴道镜检查结合宫颈醋酸涂抹检查与病理检查总符合率为81.18%,明显高于液基细胞学检查。结论阴道镜检查结合醋酸涂抹及组织活检可作为宫颈癌及癌前病变的常规筛查方法之一。
Objective To investigate the significance of colposcopy combined with biopsy in cervical cancer and cervical intraepithelial neoplasia (CIN). Methods A total of 750 outpatients were randomly selected from outpatients obstetrics and gynecology clinic in our hospital from 2000 to the present. All the patients with systemic diseases without vaginal inflammation and vaginal inflammation before examination were examined with colposcopy At the same time, cervical smears of 5% acetic acid were applied and multiple biopsies were performed in the lesion area, especially at the junction of squamous epithelium and abnormal lesions. Among them, 170 patients underwent cervical cytology (LPT) examination with consent. Results In the pathological results of the 750 cases examined, inflammatory changes were found in 487 cases (63.62%), CIN Ⅰ grade in 153 cases (21.16%), CIN Ⅱ grade in 68 cases (9.42%) and CIN Ⅲ grade in 21 cases (2.90% . Cervical cancer in 21 cases, accounting for 2.90%. The coincidence rate of cervical liquid-based cytology (LPT) and pathology was 38.82%. The total coincidence rate of colposcopy combined with cervical smear and pathological examination was 81.18%, which was significantly higher than that of liquid-based cytology. Conclusions Colposcopy combined with acetic acid smear and biopsy can be used as one of the routine screening methods for cervical cancer and precancerous lesions.