【摘要】 目的:评价液基细胞学检查(liquid-based pap test,LPT)配合阴道镜检查对子宫颈病变的诊断价值。方法:收集妇科门诊就诊患者11 709例,先后进行LPT检查和阴道镜检查,对细胞学检查或阴道镜检查异常的6223例进行活检。结果:宫颈癌前病变(CIN)的高发年龄为30~40岁,宫颈癌的高发年龄为50~60岁。LPT和阴道镜对对低度鳞状上皮内瘤变(LSIL)、高度鳞状上皮内瘤变(HSIL)、宫颈浸润癌的诊断符合率逐级显著升高;LPT和阴道镜对宫颈病变的诊断敏感性分别为49.02%和80.00%,特异性分别为97.03%和99.08%,差异有显著性。病理诊断中宫颈湿疣者共467例,占所有阳性诊断的54.00%;LPT和阴道镜对单纯宫颈湿疣的漏诊率分别为69.06%和35.91%。结论:LPT诊断宫颈病变敏感性较低,LPT联合阴道镜检查可以提高宫颈病变筛查的准确性,有利于早期诊断宫颈癌及癌前病变。LPT和阴道镜对宫颈湿疣的漏诊率较高,对HPV的检测或将成为宫颈病变的常规筛查手段。更多还原

【Abstract】 Objective:To assess the value of liquid-based pap test(LPT)and colposcopy in the diagnosis of cervical lesion.Methods:Eleven thousand seven hundred and nine outpatients were given LPT and colposcopy.Cervical biopsies under the guidance of colposcopy were taken in 6223 cases,which were found abnormal by LPT or colposcopy.Results:Cervical intraepithelial neoplasia(CIN)was more likely happened in women aged 30～40 years,while cervical carcinoma was more likely happened in women aged 50～60 years.The diagnosis accordance rate of high grade squamous intraepithelial lesion(HSIL)was significantly higher than that of low grade squamous intraepithelial lesion(LSIL)and was significantly lower than that of carcinoma for both LPT and colposcopy.Sensitivity and specificity were 49.02% and 97.03% for LPT and 80.00% and 99.08% for colposcopy.The sensitivity and specificity of colposcopy were significantly higher than those of LPT.Four hundred and sixty-seven cases of venereum papilloma were found through biopsy.The proportion of venereum papilloma in positive cases reached 54.00%.The rate of missed diagnosis of venereum papilloma was 69.06% for LPT and 35.91% for colposcopy.Conclusion:LPT alone is not sensitive for detecting cervical lesion.LPT,combined with colposcopy,could improve the accuracy of screening.The high rate of missed diagnosis for venereum papilloma indicates the necessity of human papilloma virus testing.更多还原