固有荧光宫颈病变图像诊断技术的临床应用研究  

Clinical Study of Intransic Fluorescence Image-Diagnostic Technique for Diagnosis of Cervical Lesions

作　　者：康俭[1] 刘建华[1] 顾玮玲[1] 张勤 KANG Jian;LIU Jian-hua;GU Wei-ling;ZHANG Qin(Department of Obstetrics and Gynecology,Shanghai 9th People＇s Hospital Afliated to Shanghai Jiaotong University School of Medicine Shanghai 200011)

机构地区：[1]上海交通大学医学院附属第九人民医院,上海200011

出　　处：《中国医疗器械信息》2018年第21期63-66,134,共5页China Medical Device Information

摘　　要：目的:探讨固有荧光宫颈病变图像诊断技术(以下称固有荧光技术)在宫颈癌前病变及早期浸润癌检查和诊断中的价值。方法:对135例宫颈病变患者应用固有荧光技术和阴道镜技术进行宫颈检查,根据检查情况对宫颈定位点活检。以病理诊断为金标准,对照分析固有荧光技术和阴道镜检查宫颈病变结果,观察固有荧光技术诊断宫颈病变的灵敏度、特异度、阳性预测值和准确度。结果:固有荧光技术在宫颈病变检查中,诊断宫颈浸润癌灵敏度90.9%、特异度100%、准确度99.3%,与阴道镜无显著性差异(灵敏度90.9%、特异度100%、准确度99.3%);固有荧光技术诊断HSIL的灵敏度80%、特异度93.6%、准确度91.1%,与阴道镜(灵敏度84%、特异度87.3%、准确度86.7%)无显著性差异(P>0.05);固有荧光技术诊断LSIL的灵敏度50%显著低于阴道镜(82.8%)(P>0.05),但特异度77.9%、准确度65.9%与阴道镜(特异度63.6%、准确度71.9%)无显著性差异(P>0.05)。结论:固有荧光图像诊断技术诊断宫颈高级别病变和早期浸润癌的灵敏度、特异度和准确度与阴道镜相当,并且方便快捷、安全无创、图像客观直观,易于掌握,可作为一种有效的宫颈病变检查和筛查技术进一步研究、探讨。Objective： To approach the diagnostic value of intransic fuorescence image-diagnostic technique （IFIT） for cervical lesions. Methods： 135 cases of cervical lesions were examined by both colposcopy and IFIT, and according to the respective results of colposcopy and IFIT, biopsy and histopathological examination of the cervical lesions were performed. With histopathological results as the criteria, the sensitivity, specifcity, positive predictive values, and accuracy of colposcopy and IFIT were detected and compared. Results： There were not signifcant diferences in sensitivity, specifcity, and accuracy of the diagnosis of cervical high grade squamous intraepithelial lesion（HSIL） and early invasive carcinoma between colposcopy and IFIT （P〉0.05 respectively）. For the diagnosis of low grade squamous intraepithelial lesion （LSIL）, the sensitivity of IFIT was signifcantly lower than that of colposcopy （P〈0.05）. However the specifcity and accuracyof IFIT were just the same as those of colposcopy in the diagnosis of LSIL （P〉0.05 respectively）. Conclusion： The sensitivity, specifcity, and accuracy of IFIT in the diagnosis of HSIL and early invasive carcinoma were as high and efective as those of colposcopy. Moreover the procedure of IFIT is safe, easy and convenient, and the image-diagnosis is objective and easy to learn. Therefore IFIT should be further studied in the diagnosis of cervical lesions.

关 键 词：固有荧光 宫颈病变 图像诊断技术 阴道镜检查 

分 类 号：R711.74[医药卫生—妇产科学]