【摘要】 目的:评价宫颈细胞学涂片联合阴道镜检查对子宫颈病变的诊断价值。方法:2003年10月～2006年10月采用宫颈细胞学涂片联合阴道镜检查筛查10326例患者,以组织学诊断为金标准对结果进行分析。结果:10326例中,阴道镜下活检1560例,异常涂片1379例(13.35%)。病理结果显示:急慢性炎症890例(8.62%),宫颈上皮内瘤样病变(CIN)414例(3.04%)。其中CINⅠ220例(2.13%),CINⅡ108例(1.05%),CINⅢ及原位癌86例(0.83%),宫颈浸润癌89例(0.86%),HPV感染155例(1.5%),子宫内膜异位症7例(0.07%),子宫肌瘤5例(0.05%)。宫颈细胞学检查诊断CIN符合率为64.04%,阴道镜检查为93.48%,两者比较差异显著性(χ2=103.13,P<0.005),两者联合对CIN检出率为4.01%。阴道镜诊断CIN的敏感性为93.48%,特异性为89.69%,两者联合对CIN的诊断阳性预测值为73.57%,阴性预测值为97.14%。结论:采用宫颈细胞学联合阴道镜下病理组织检查能提高宫颈癌前病变及早期宫颈癌的诊断率,在经济欠发达区域可作为宫颈病变的筛查方法,具有群防群治的重要价值。更多还原

【Abstract】 Objective:To evaluate the efficiency of cytologic examination of cervical smear combined1with biopsy under colposcopy in diagnosis of cervical squamous intraepithelial lesions.Methods:From October 2003 to October 2006,there were 10326 women accepting the screening for cervical lesion by cytologic smear combined with biopsy under colposcopy in our institute.Pathologic examization of biopsy under colposcopy was assumed as gold "standard".Results:Among 10326 cases,1379 cases(13.35%)were diagnosed as abnormal by cytologic smear.The pathologic examination shown that 890(8.62%)with acute or chronic infections,414 with cervical intraepithelial neoplasia(CIN),of with 220 cases of CIN Ⅰ,108 of CINⅡ,86 of CIN Ⅲ,89 cases with cervical squamous intraepithelial cancer,155(1.50%)with HPV infections,7 cases with endometriowis,5 cases with uterine myoma.Coincide rate of diagnosing CIN was 64.04% and 93.48% for cytologic examination of cervical smear and for colposcopy examination,respectively.The difference of coinciden rates was statistically significant(χ2=103.13,P<0.005).The occurrence of CIN was 4.01% by the double.The sensitivity,specificity,positive predictive value(PPV)and negative predictive vamue(NPV)of solposcopy in evaluation of CIN were 93.48%,89.69%,73.57%.and 97.14%Conclusion:The occurrence of CIN and the early stage uterus neck cancer is increasing recuntly and cytologic examination of cervical smear combined with biopsy under colposcopy are recommended to be as routine screening to the dentify precancerous lesions.It has important value for the control uterus neck cancer in depressed rural areas.更多还原