阴道镜下宫颈活检诊断子宫颈上皮内瘤变120例临床分析  

Clinical Analysis of Colposcopically Directed Cervical Biopsy in the Diagnosis of Cervical Intraepithelial Neoplasia in 120 Cases

作　　者：刘兆董[1] 高金华 吕冰清[1] LIU Zhao-dong GAO Jin-hua LV Bing-qing(Department of Gynecology, Fujian Provincial Maternity and Children ~ Hospital, Fuzhou 350001, China Department of Cervix clinic, Datian County Maternal and Children＇s Health Hospital, Sanming 366100, China)

机构地区：[1]福建省妇幼保健院妇科,福建福州350001 [2]大田县妇幼保健院宫颈门诊,福建三明366100

出　　处：《中国医药指南》2017年第19期42-44,共3页Guide of China Medicine

摘　　要：目的探讨阴道镜直视下宫颈活检诊断子宫颈上皮内瘤变(CIN)的准确性及临床价值。方法回顾性分析阴道镜直视下活检诊断为CIN,并在短期内行子宫颈环形电切术(LEEP)的120例患者的临床及病理资料。结果 120例患者中,阴道镜下活检和LEEP术后病理检查结果完全相同的83例,总体符合率69.17%,其中诊断CIN低级别(CINⅠ)符合率78.21%(61/78),CIN高级别(CINⅡ、CINⅢ)符合率76.19%(32/42)。诊断不足者27例,占22.5%,诊断过度者10例,占8.33%。阴道镜下活检诊断低级别CIN中,未发现癌的漏诊,诊断高级别CIN中,最后确诊早期浸润癌1例,癌的漏诊率0.83%(1/120)。结论阴道镜下宫颈活检是初步诊断CIN的一种简单有效方法,具有一定的临床应用价值。但对于最后确诊CIN存在一定局限性,尤其是在诊断高级别CIN时,有宫颈浸润癌漏诊的可能。LEEP可提高其诊断准确性。Objective To evaluate the accuracy and clinical value of colposcopically directed cervical biopsy in the diagnosis of cervical intraepithelial neoplasia（CIN）. Methods The clinical and pathological data of 120 patients with CIN diagnosed by colposcopically directed cervical biopsy and treated with loop electrosurgical excision procedure（LEEP） shortly after were analyzed retrospectively. Results Among 120 patients, there were 83 patients with colposcopic biopsy and LEEP pathological examination results in exactly the same, consistent with the overall rate of 69.17%. The consistence rate of low grade CIN（CIN I） was 78.21%（61/78）, high grade CIN（CIN II and CINⅢ） with the consistence rate was 76.19%（32/42）. There were 27 cases of underdiagnosis（22.5%） and 10 cases of overdiagnosis（8.33%）. There was not found the missed diagnosis of cancer in the low grade CIN, however, there was found one cases early invasive carcinoma in the high grade CIN. The rate of missed diagnosis of cancer was 0.83%（1/120）. Conclusions Colposcopically directed cervical biopsy is a kind of simple and effective method in the preliminary diagnosis of CIN, It has a certain clinical application value. But in the final diagnosis of CIN has some limitations, especially in the diagnosis of high grade CIN, it has The possibility of missed diagnosis of cervical invasive cancer. LEEP can improve the diagnostic accuracy.

关 键 词：宫颈上皮内瘤变 阴道镜 宫颈活检 子宫颈环形电切术 病理 

分 类 号：R711.74[医药卫生—妇产科学]