六种检测手段在宫颈病变分级诊断中的临床应用分析  

Clinical application of six detection methods in the classification of cervical lesions

作　　者：冯涛[1] 张妍[2] 

机构地区：[1]枣庄科技职业学院医学技术系,山东滕州277500 [2]枣庄市妇幼保健院病理科,山东枣庄277100

出　　处：《泰山医学院学报》2017年第10期1095-1097,共3页Journal of Taishan Medical College

基　　金：山东省枣庄市科技卫生发展计划项目(No.2015033)

摘　　要：目的探讨六种检测手段在宫颈病变分级诊断中的临床应用价值。方法选取2008年1月—2015年12月入院宫颈门诊同时行TCT、HPV高危分型检测及COL检查的患者1000例,并对其中1项及1项以上异常者取病理活检,以病理检查结果为金标准,对比6种检测手段的漏诊率及误诊率及宫颈病变不同分级中的漏诊率。结果TCT检查组、HPV高危分型检查组、COL检查组、TCT+HPV高危分型检查组、TCT+COL检查组及TCT+HPV高危分型+COL检查组的漏诊率分别为17.14%(18/105)、38.10%(40/105)、50.48%(53/105)、7.62%(8/105)、11.43%(12/105)及0(0/105);误诊率分别为1.68%(15/895)、3.46%(31/895)、3.69%(33/895)、5.59%(50/895)、5.81%(52/895)及6.15%(55/895)。结论 TCT+HPV高危分型+COL在诊断早期宫颈病变中漏诊率低,容易发现早期宫颈病变患者,在早期宫颈病变诊断中具有优势,TCT及HPV高危分型检查在诊断高度宫颈病变和宫颈癌中漏诊率较低,差异无统计学意义,为避免人员及资源浪费可以选取其中一种检查手段,阴道镜检查鳞状上皮内瘤变诊断率较高,但易漏诊,需慎重单选用。Objective： To explore the clinical application value of six kinds of detection methods in the grading diagnosis of cervical lesions. Methods： 1000 patients received thinprep cytologic（ TCT）,human papillomavirus（ HPV） of high-risk type and colposcopy examination（ COL） in our outpatients from January 2008 to December 2015. Pathological biopsy was performed on patients with one or more abnormal diagnosis results. In pathological examination as the gold stangard,compared to the six kinds of detection＇s omission diagnostic rate,mistake diagnostic rate and the rate of omission diagnostic in different grades of cervical. Results： TCT inspection group,high-risk type HPV points inspection group,COL inspection group,TCT and high-risk classification HPV inspection group,TCT and COL inspection group and TCT and high-risk classification HPV and COL inspection group of missed diagnosis was 17. 14%（ 18/105）,38. 10%（ 40/105）,50. 48%（ 53/105）,7. 62%（ 8/105）,11. 43%（ 12/105） and 0（ 0/105）; The mis diagnosis rate was 1. 68%（ 15/895）,3. 46%（ 31/895）,3. 69%（ 33/895）,5. 59%（ 50/895）,5. 81%（ 52/895） and 6. 15%（ 55/895）. Conclusion： TCT and high-risk classification type HPV and COL in the diagnosis of early cervical lesions in the missed diagnosis is low,easy to find early cervical lesions in patients,to have an advantage in the early diagnosis of cervical lesions,height of TCT and high-risk HPV parting examination in the diagnosis of cervical disease and cervical cancer in missed diagnosis is low,there was no statistically significant difference,in order to avoid personnel and resource waste can select one of inspection means,colposcope examination squamous intraepithelial neoplasia diagnostic rate is higher,but easy to miss,singla use COL carefully check.

关 键 词：TCT检查 HPV高危型检查 COL检查 宫颈病变 活体组织检查 

分 类 号：R737.33[医药卫生—肿瘤]