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目的探讨宫颈刮片与阴道镜检查在诊断宫颈上皮内瘤变(CIN)的临床应用。方法通过对100例有接触性出血等临床可疑症状的CIN患者分别行宫颈刮片和阴道镜检查,然后以病理组织学诊断为金标准,用敏感性、特异性、假阴性率、假阳性率及诊断符合率进行对比分析。结果 386例患者行病理组织血诊断后确诊93例患者异常,其中CINⅠ38例、CINⅡ26例、CINⅢ10例、HPV感染伴部分CIN改变16例、微小浸润癌3例。阴道镜检查结果与宫颈刮片细胞学检查结果比较,其诊断敏感性、假阳性率、假阴性率、诊断符合率均差异均有统计学意义(均P<0.05),而特异性差异无统计学意义(P>0.05)。结论将宫颈刮片与阴道镜检查联合使用,镜下定位取活体组织进行病理诊断,既避免常规四点活检的盲目性,又能减少各自的假阴性率及假阳性率,降低漏诊率,提高诊断率。
Objective To investigate the clinical application of cervical smears and colposcopy in the diagnosis of cervical intraepithelial neoplasia (CIN). Methods Cervical smears and colposcopy were performed on 100 cases of clinically suspected symptoms of CIN with contact bleeding, and then diagnosed by histopathology as the gold standard. The sensitivity, specificity, false negative rate, false positive rate And the diagnostic coincidence rate of comparative analysis. Results A total of 386 patients were diagnosed as pathological tissue abnormalities, of which 93 were diagnosed as CIN Ⅰ, 26 as CIN Ⅱ, 10 as CIN Ⅲ, 16 as CIN, and 3 as invasive carcinoma. The results of colposcopy and cervical smear cytology showed that there were significant differences in diagnostic sensitivity, false positive rate, false negative rate and diagnostic coincidence rate (all P <0.05), while no statistical difference was found Significance (P> 0.05). Conclusion Combined use of cervical smear and colposcopy, microscopic localization of living tissue for pathological diagnosis, both to avoid the blindness of the conventional four-point biopsy, but also reduce their false-negative rate and false positive rate, reduce the rate of missed diagnosis and increase Diagnostic rate.