【摘要】 目的:分析在阴道镜下进行活检及在宫颈环形电切手术后进行病理检查对于宫颈病变的诊断意义。方法:选取在我院经人乳头状瘤病毒检测及宫颈细胞学检查发现异常,或在检查无发现异常但经肉眼发现宫颈柱状上皮出现中重度外翻的患者548例,对这些患者进行阴道镜下宫颈活检及宫颈环形电切术,对比宫颈环形电切术前后的病理诊断结果的改变。结果:阴道镜下宫颈活检诊断结果与LEEP术后病理检查结果的符合率为49.27%;两种诊断方法对CIN分期Ⅱ/Ⅲ级及原位癌诊断的一致性经Kappa分析,Kappa=0.63,一致性较高;阴道镜下宫颈活检与LEEP术后病理检查总的准确诊断率分别为82.30%、68.43%,对诊断CINⅡ/Ⅲ级的准确诊断率分别为79.63%、81.48%,漏诊断率分别为20.37%、18.52%;阴道镜下宫颈活检与LEEP术后病理检查对CINⅡ/Ⅲ级及原位癌的诊断与联合诊断的一致性分析,K值分别是0.80、0.83。结论:阴道镜下宫颈活检及宫颈环形电切术后的病理检查对诊断宫颈病变的诊断结果具有较高的一致性,两种方法联合诊断能显著的提高诊断的准确性。更多还原

【Abstract】 Objectives: To analyze application value of colposcope cervical biopsy and pathological examination in the diagnosis of cervical lesions after loop electrosurgical excision procedure. Methods: 548 patients who received human papilloma virus detection in our hospital with abnormal cervical cytology,or who had moderate- to- severe cervical columnar epithelium were selected. Colposcope cervical biopsy and loop electrosurgical excision procedure were performed. Pathological diagnosis results before and after the procedure was compared. Results:Coincidence rate of colposcopic cervical biopsy and pathological examination results after LEEP was 49. 27%; kappa analysis was conducted on the consistency of two diagnostic methods on CIN stage II / III and carcinoma and Kappa= 0. 63,with high consistency; correct diagnosis rates of colposcopy cervical biopsy and LEEP postoperative pathology check were 82. 30% and 68. 43% respectively. In the diagnosis of CIN II / III,the accurate diagnosis rates were respectively 79. 63% and 81. 48%; missed diagnosis rates were respectively 20. 37% and 18. 52%; consistency analysis on colposcopic cervical biopsy and LEEP postoperative pathologic examination in diagnosis of CIN II /III and carcinoma showed that K value were 0. 80 and 0. 83 respectively. Conclusion: Colposcopic cervical biopsy and LEEP postoperative pathologic examination have high consistency in the diagnosis of cervical lesions,the combined diagnosis of which can significantly improve the diagnostic accuracy.更多还原