经阴道彩色多普勒超声联合阴道镜诊断宫颈癌临床价值  

Clinical value of transvaginal color Doppler ultrasound combined with colposcopy in the diagnosis of cervical cancer

作　　者：白芳芳[1] 邸海燕[1] 张娜[1] 刘巍[1] 杨震[1] 胡文宇[1] BAI Fang-fang;DI Hai-yan;ZHANG Na;LIU Wei;YANG Zhen;HU Wen-yu(Department of Function, the Second Central Hospital of Baoding, Hebei Province, Baoding 071000, China)

机构地区：[1]河北省保定市第二中心医院功能科,河北保定071000

出　　处：《河北医科大学学报》2021年第4期439-443,共5页Journal of Hebei Medical University

基　　金：保定市科学技术研究与发展指导计划(18ZF103)。

摘　　要：目的探讨经阴道彩色多普勒超声、阴道镜及两者联合诊断宫颈癌的价值,为临床诊断提供帮助。方法回顾性分析经病理诊断的早期宫颈癌患者62例、非宫颈癌患者28例(癌前病变19例、正常宫颈9例),均进行经阴道彩色多普勒超声与阴道镜检查,以病理检测结果作为金标准,比较经阴道彩色多普勒超声、阴道镜及两者联合的诊断对宫颈癌的诊断价值。结果彩色多普勒超声检出宫颈癌61例、非宫颈癌29例,与病理结果比较Kappa系数为0.769;阴道镜检出宫颈癌55例、非宫颈癌35例,与病理结果比较Kappa系数为0.588;两者联合检出宫颈癌60例、非宫颈癌30例;与病理结果比较Kappa系数为0.949。彩色多普勒超声诊断宫颈癌敏感度为91.94%、特异度为85.71%、诊断符合率为90.00%;阴道镜诊断宫颈癌敏感度为80.65%、特异度为82.14%、诊断符合率为81.11%;两者联合诊断宫颈癌敏感度为96.77%、特异度为100.0%、诊断符合率为97.78%。宫颈癌患者PSV显著低于癌前病变与正常宫颈,RI显著高于癌前病变与正常宫颈,差异有统计学意义(P<0.05)。PSV诊断宫颈癌的AUC为0.908,敏感度为90.3%,特异度为85.7%;RI诊断宫颈癌的AUC为0.819,敏感度为77.4%,特异度为67.9%。结论经阴道彩色多普勒超声、阴道镜诊断宫颈癌均具有一定价值,两者联合诊断价值更高,联合诊断可有效区分宫颈癌与癌前病变,阴道彩色多普勒超声可提供病灶血流情况,为手术治疗提供帮助。Objective To explore the value of transvaginal color Doppler ultrasound,colposcopy and their combination in the diagnosis of cervical cancer,and to provide assistance for clinical diagnosis.Methods Clinical data of 62 patients with early cervical cancer and 28 patients with non-cervical cancer(19 cases of precancerous lesions and 9 cases of normal cervix)diagnosed by pathology were retrospectively analyzed.All patients were examined by transvaginal color Doppler ultrasound and colposcopy.The results of pathological examination were taken as the gold standard to compare the diagnostic value of transvaginal color Doppler ultrasound,colposcopy and their combination in cervical cancer.Results A total of 61 cases of cervical cancer and 29 cases of non-cervical cancer were detected by color Doppler ultrasound,and Kappa coefficient was 0.769 compared with pathological results;55 cases of cervical cancer and 35 cases of non-cervical cancer were detected by colposcopy,and Kappa coefficient was 0.588 compared with pathological results.Sixty cases of cervical cancer and 30 cases of non cervical cancer were detected by combination detection of color Doppler ultrasound and colposcopy and Kappa coefficient was 0.949 compared with pathological results.The sensitivity,specificity and coincidence rate of color Doppler ultrasound in the diagnosis of cervical cancer were 91.94%,85.71%and 90.00%,respectively;the sensitivity,specificity and coincidence rate of colposcopy in the diagnosis of cervical cancer were 80.65%,82.14%and 81.11%,respectively;the sensitivity,specificity and coincidence rate of colposcopy combined with colposcopy in the diagnosis of cervical cancer were 96.77%,100.0%and 97.78%,respectively.PSV of cervical cancer patients was significantly lower than that of patients with precancerous lesions and normal cervix,RI was significantly higher than that of precancerous lesions and normal cervix,and the difference was statistically significant(P<0.05).The AUC of PSV in diagnosis of cervical cancer was 0.908,and sensitivi

关 键 词：宫颈肿瘤 超声检查 多普勒 彩色 阴道镜检查 

分 类 号：R737.33[医药卫生—肿瘤]