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目的评价薄层液基细胞学制片联合阴道镜检查对宫颈病变的诊断价值。方法对2006年1月～2008年12月在哈尔滨医科大学附属第四医院妇科门诊检查的1220例患者行宫颈薄层液基细胞学制片(TCT)检查,对其中186例细胞学提示阳性或临床高度可疑的患者行阴道镜下活组织病理检查,以病理诊断为金标准,对结果进行分析。结果宫颈薄层液基细胞学制片检查1220例中,异常涂片157例(12.59%),临床高度可疑的患者45例行阴道镜检查下活检。病理结果显示:CINⅠ39例,CINⅡ9例,CINⅢ3例,子宫颈鳞癌3例。TCT检查诊断宫颈病变符合率为84.0%,阴道镜检查对宫颈病变的诊断符合率为88.0%,两者比较差异具有显著性(P<0.05),二者联合病变检出率为98.0%。结论采用薄层液基细胞学制片检查配合阴道镜下病理检查可明显提高对宫颈病变诊断的准确率,能满足早期发现癌前病变的需要。
Objective To evaluate the diagnostic value of thin-layer liquid-based cytology and colposcopy in the diagnosis of cervical lesions. Methods From January 2006 to December 2008, 1220 patients underwent gynecological outpatient examination at the Fourth Affiliated Hospital of Harbin Medical University underwent cervical thin-layer liquid-based cytology (TCT) examination, of which 186 were cytologically positive or Patients with highly suspicious clinical colposcopy under biopsy pathology, pathological diagnosis as the gold standard, the results were analyzed. Results Among the 1220 cases of cervical smear-based cytology, 157 cases (12.59%) were abnormal smears, and 45 cases of highly suspicious patients underwent colposcopy biopsy. Pathological results showed that: CINⅠ39 cases, CINⅡ9 cases, CINⅢ cases, cervical squamous cell carcinoma in 3 cases. The coincidence rate of TCT in diagnosis of cervical lesions was 84.0%. The coincidence rate of colposcopy in diagnosis of cervical lesions was 88.0%. There was significant difference between them (P <0.05). The detection rate of combined lesions was 98.0%. Conclusion Thin-layer liquid-based cytology examination with colposcopy pathological examination can significantly improve the diagnostic accuracy of cervical lesions, to meet the needs of early detection of precancerous lesions.