【摘要】 目的 评价阴道镜检查对宫颈上皮内瘤样病变(CIN)的诊断价值。方法 对1991年5月至2002年4月进行阴道镜检查的患者1407例,行镜下定位取活组织病理检查。结果 近4年来CIN的发病例数呈上升趋势,发病年龄在30-39岁的病例占80.29％。经病理确诊CIN 406例,包括CIN Ⅰ 209例、CINⅡ104例和CINⅢ(包括CIS)93例;慢性宫颈炎625例,湿疣187例,息肉139例,其他50例(包括宫颈纳氏囊肿28例,子宫内膜异位症13例,乳头状瘤9例)。阴道镜检查对CIN的诊断准确性为79.67％,敏感性为96.06％,特异性为73.03%,阳性预测值为59.09％,阴性预测值为97.86％。CIN在阴道镜下的图像以醋酸白色上皮的出现率最高为83.50％,对CIN诊断的敏感性和阴性预测值高;与点状区和(或)镶嵌同时存在时,对CIN诊断的敏感性下降,特异性升高。结论 阴道镜检查对CIN的诊断价值在于其敏感性和阴性预测值高,在国内适合作为CIN的筛查方法。统一阴道镜的评分标准意义重大。更多还原

【Abstract】 Objective To evaluate the value of colposcopy in the diagnosis of cervical intraepithelial neoplasia (CIN). Methods Colposcopic inspections and biopsies were performed on 1 407 women between May 1991 and April 2002 in our hospital. Results The incidence of CIN increased significantly after 1999. The proportion of the patients between the age of 30 to 39 were 80. 29%. 406 women were histopathologically confirmed suffering with CIN, included 209 with CIN Ⅰ ,104 with CIN Ⅱ and 93 with CIN Ⅲ (including CIS) ;625 with chronic cervicitis,187 with condyloma acuminate, 139 with polyps and 50 with others(28 Naboth cyst, 13 endometriosis and 9 papillomas). The accuracy,sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of colposcopy in evaluation of CIN were 79. 67% ,96. 06% ,73. 03% ,59. 09% and 97. 86% .respectively. 83. 50% of the cases with CIN showed acetowhite epithelium under colposcopy which showed high sensitivity and NPV. In the cases with punctation and/or mosaic, the sensitivity decreased while the specificity increased/Conclusion The value of colposcopy in diagnosis of CIN is its high sensitivity and NPV. Colposcopy is suitable for CIN screening. It is quite important to unify the colposcopic grading index.更多还原