128例阴道镜检查宫颈多点活检和宫颈管诊刮术诊断宫颈病变的临床价值  

Clinical analysis of 128 cases of cervical lesion diagnosed by multi-point biopsy of colposcopy and endocervical curettage

作　　者：刘蓓蓓[1] 朱意玲 章文华 张红[1] 王新霞[1] 余晓娟 张萍[1] 张杰[1] 王岚[1] 方师文 李丹 郑诗雯 卢敏华 Liu Beibei;Zhu Yanling;Zhang Wenhua;Zhang Hong;Wang Xinxia;Yu Xiaojuan;Zhang Ping;Zhang Jie;Wang Lan;Fang Shiwen;Li Dan;Zhen Shiwen;Lu Minhua(Department of Gynecologic Oncology,Xuzhou Cancer Hospital,Xuzhou 221000,China;Department of Pathology,Xazhou Cancer Hospital,Xuzhou 221000,China;Department of Gynecologic Oncology,National Cancer Center/National Clincal Research Center for Caneer/Caneer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beifing 100021,Chin)

机构地区：[1]徐州市肿瘤医院妇瘤科,221000 [2]徐州市肿瘤医院病理科,221000 [3]国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院妇瘤科,100021

出　　处：《中华肿瘤杂志》2018年第7期539-542,共4页Chinese Journal of Oncology

摘　　要：目的探讨阴道镜检查、宫颈多点活检和宫颈管诊刮术（ECC）在宫颈病变诊断中的临床价值。方法回顾性分析2014年1月23日至2016年10月11日就诊于徐州市肿瘤医院128例患者的临床资料，所有患者均行阴道镜检查及宫颈活检和（或）ECC。结果128例患者中，30。50岁患者70例，其中转化区类型为I型28例（40．0％），Ⅱ型23例（32．9％），Ⅲ型19例（27．1％）；〉50岁患者45例，其中转化区类型为Ⅱ型1例（2．2％），Ⅲ型44例（97．8％）。128例患者中，阴道镜诊断慢性炎症57例，宫颈上皮内瘤样病变（CIN）I级35例，CINⅡ级＋CINⅡ～Ⅲ级8例，CINII级5例，可疑浸润癌23例。病理诊断慢性炎症81例，CINI级17例，CINⅡ级＋CINⅡ～Ⅲ级7例，CINⅢ级5例，宫颈癌18例。慢性炎症或化生患者81例，与阴道镜检查符合52例（64．2％）；低级别鳞状上皮细胞病变17例，与阴道镜检查符合10例；高级别鳞状上皮细胞病变（HSIL）12例，与阴道镜检查符合9例；宫颈癌18例，与阴道镜检查符合17例。结论宫颈转化区类型与年龄呈正相关，转化区类型有助于活检和治疗方式的选择。阴道镜下宫颈多点活检和（或）ECC对HSIL和早期宫颈癌有较高的诊断准确率。阴道镜检查可发现肉眼难以鉴别的阴道受侵情况，为宫颈癌ⅡA期患者制订个体化的治疗方案提供客观依据。Objective To investigate the clinical values of colposcopy and cervical biopsy and/or endocervical curettage （ECC） in the diagnosis of cervical lesion. Methods Clinical data of 128 cases of cervical lesion diagnosed by Xuzhou Cancer Hospital from January 23, 2014 to October 11, 2016 were collected and retrospectively analyzed, all patients underwent colposcopy and cervical biopsy and/or ECC. Results Among them, the age between 30 to 50 years old were 70 cases, whose transformation zone types of Ⅰ , Ⅱ and Ⅲ were 28 cases （40.0%） , 23 cases （32.9%） and 19 cases （27.1%） , respectively. The age older than 50 years were 45 cases, whose transformation zone types of Ⅱ and Ⅲ were Ⅰ case （2.2%） and 44 cases （97.8%）, respectively. Among the 128 cases of cervical lesions, diagnostic results of colposcopy showed that the chronic inflammation were 57 cases, cervical intraepithelial neoplasia （CIN） I were 35 cases, CIN Ⅱ or CIN Ⅱ - m were 8 cases, CIN m were 5 cases and cervical cancer were 23 cases. Alternatively, the pathological results showed that the chronic inflammation were 81 cases, CIN I were 17 cases, CIN Ⅱ or CIN Ⅱ-Ⅲ were 7 cases, CIN Ⅲ were 5 cases and cervical cancer were 18 cases,respectively. Among the 81 cases of chronic inflammation diagnosed by pathology, 52 cases （64.2%） were consistent with the diagnostic results of colposcopy. Among the 17 cases of low grade squamous epithelial cell lesion （LSIL） diagnosed by pathology, 10 cases were in agree with the diagnostic results of colposcopy. Among the 12 cases of high-grade squamous epithelial cell lesion （HSIL） diagnosed by pathology, 9 cases were concordant with the diagnostic results of colposcopy. Among the 18 cases of cervical cancer diagnosed by pathology, 17 cases were consistent with the diagnostic results of colposcopy. Conclusions The type of transformation zone is positively correlated with the age, and it can help to choose biopsy and therapeutic manner. The diagnostic accuracies of HSIL

关 键 词：宫颈病变 阴道镜检查 宫颈多点活检 宫颈管诊刮术 

分 类 号：R737.33[医药卫生—肿瘤]