宫颈多点活检及宫颈管搔刮联合宫颈环形电切术在宫颈上皮内瘤变中的临床诊断价值分析  

Analysis on the values of cervical multi- point biopsy,endocervical curettage combined with cervical LEEP in clinical diagnosis of CIN

作　　者：覃冬莉[1] 

机构地区：[1]广西壮族自治区南宁市妇幼保健院,530000

出　　处：《中国妇幼保健》2014年第33期5502-5504,共3页Maternal and Child Health Care of China

基　　金：国家卫生与计划生育委员会项目〔2011-12号〕

摘　　要：目的：对比分析阴道镜下宫颈多点活检及宫颈管搔刮联合宫颈环形电切术（LEEP）在宫颈上皮内瘤变（CIN）中的诊断价值。方法：选取2010年1月~2013年12月在该科宫颈细胞学检测异常,进一步行阴道镜下宫颈多点活检＋宫颈管搔刮提示CIN的患者100例,反复宫颈细胞学检测异常及HPV持续阳性,但阴道镜下宫颈多点活检＋宫颈管搔刮阴性12例,共112例。行LEEP术后对比宫颈多点活检＋宫颈管搔刮和LEEP术后病理结果诊断的一致性。同时分析患者细胞学和HPV结果与宫颈CIN误诊的关系。结果：宫颈多点活检＋宫颈管搔刮同LEEP术最终病理诊断符合者71例（63.39%）,不符合者41例（36.61%）,其中诊断过度者18例（16.07%）,诊断不足者23例（23.54%）。两种检测方法在CIN-I的检测中存在统计学差异,P〈0.05。宫颈CIN的误诊和ASC-H及以上与HPV阳性显著相关,P〈0.05。结论：阴道镜下宫颈多点活检＋宫颈管搔刮诊断CIN可能存在一定的误诊及漏诊,进一步行LEEP术可通过提供完整组织标本弥补阴道镜检查的不足。Objective： To compare and analyze the values of colposcopic cervical multi - point biopsy, endocervical curettage combined with cervical loop electrosurgical excision procedure （LEEP） in clinical diagnosis of cervical intraepithelial neoplasia （CIN） . Methods ： One hundred patients diagnosed as CIN by cervical cytological test, colposeopic cervical multi - point biopsy and endocervical curettage in the hospital from January 2010 to December 2013 were selected; 12 patients with abnormal cytological test result, persistent positive HPV and negative result of colposcopic cervical multi - point biopsy and endoeervieal curettage were selected during the same period. After LEEP, the coincidence rate of colposeopic cervical multi - point biopsy combined with endoeervical curettage and pathological examination was calculated. The relationship between cytological test, HPV detection result and cervical CIN misdiagnosis was analyzed. Results： The coinci- dence rate of eolposcopic cervical multi -point biopsy combined with endocervieal curettage and pathological examination was 63.39% （71 cases） , the misdiagnostie rate was 36. 61% （41 cases） , including overdiagnosis in 18 cases （ 16. 07% ） and underdiagnosis in 23 cases （ 23.54% ） . There was statistically significant difference in detection of CIN Ⅰ between the two detection methods （ P 〈 0. 05 ） . CIN misdiagnosis was positively correlated with ASC - H and above and positive HPV （ P 〈 0. 05 ） . Conclusion ： Colposeopic cervical multi - point biopsy combined with endocervical curettage has a certain probability of misdiagnosis and missed diagnosis in diagnosing C1N, further conducting LEEP can make up the disadvantages of eolposcopy by providing complete tissue specimens.

关 键 词：阴道镜 宫颈多点活检 宫颈管搔刮 宫颈环形电切术 宫颈上皮内瘤变 

分 类 号：R711.74[医药卫生—妇产科学]