阴道镜指引下多点活检在宫颈上皮内瘤样病变诊断中的作用  

Effect of colposcopy- directed cervical biopsy in the diagnosis of cervical intraepithelial neoplasm

作　　者：刘燕[1] 陈锐[1] 毕蕙[2] 

机构地区：[1]北京市第二医院妇科,北京100031 [2]北京大学第一医院妇产科,北京100034

出　　处：《中国性科学》2015年第9期37-40,共4页Chinese Journal of Human Sexuality

摘　　要：目的:比较阴道镜指引下多点活检与宫颈锥切术后病理结果的差异,评价阴道镜指引下宫颈活检在高级别宫颈上皮内瘤变(CINⅡ,Ⅲ)诊断中的作用。方法:645例阴道镜指引下多点活检病理为CINⅡ及以上级别病变(CINⅡ+)的患者行子宫颈锥切术,对比锥切术前后的病理结果。结果:阴道镜指引下多点活检诊断CINⅡ+敏感度95.0%,特异度46.2%,子宫颈锥切术前后CINⅡ,Ⅲ病理的一致性72.86%,漏诊宫颈浸润癌2.22%。结论:阴道镜指引下子宫颈多点活检是诊断CINⅡ,Ⅲ的一种简单而有效的方法,与子宫颈锥切术后的病理一致性为72.86%,进一步处理的选择应综合评估。Objectives：To compare the pathology result difference between trachelectomy and colposcopy -directed cervical biopsy to evaluate the diagnostic effectiveness of colposcopy -directed punch biopsies for the pa-tients with high -level cervical lesions （CIN Ⅱ and CIN Ⅲ）.Methods：645patients with CIN Ⅱ and CIN Ⅲ di-agnosed by pathology of punch biopsy under colposcopy were followed by trachelectomy.The comparison of histologi-cal pathology was made between the two procedures.Results：The sensitivity of colposcopy -directed punch biop-sies was 95%,while the specificity was 46.2%.The consistence rate between punch biopsy and excisional proce-dures was 72.86% （459 /630）.2.22% of the punch biopsy was upgraded to be invasive carcinoma by excisional procedures.Conclusions：Colposcopy -directed punch biopsy is a simple and effective method for diagnosing CINⅡ and CINⅢ,which has a consistence rate of 72.86% with excisional procedures.Further choice needs compre-hensive evaluation.

关 键 词：子宫颈锥切术 阴道镜指引下活检 宫颈上皮内瘤变 

分 类 号：R737.2[医药卫生—肿瘤]