阴道镜阴性象限活检、ECC及TCT联合检测在宫颈高级别病变中的诊断价值  

Clinical Value of Colposcopy Negative Quadrant Biopsy,ECC and TCT Combined Detection in the Diagnosis of High-grade Cervical Lesions

作　　者：潘琳 孙莉[1] 宋文榕[1] PAN Lin;SUN Li;SONG Wen-rong(Department of Gynecology,Beijing Hepingli hospital,Beijing 100013)

机构地区：[1]北京市和平里医院妇科,北京100013

出　　处：《医学临床研究》2021年第8期1179-1182,1186,共5页Journal of Clinical Research

摘　　要：【目的】探讨阴道镜阴性象限活检、宫颈管搔刮术(ECC)及液基薄层细胞检测(TCT)联合检测在宫颈高级别病变(HSIL)中的诊断价值。【方法】选取2020年3月至2021年3月在本院行人乳头状瘤病毒(HPV)筛查异常的185例患者作为研究对象,需要进一步行阴道镜阴性象限活检、ECC及TCT检查,所有患者均行宫颈锥切术组织病理学检查,以宫颈锥切术后组织病理学检查结果为金标准,分析阴道镜阴性象限活检、ECC、TCT单独及联合诊断HSIL+与病理诊断结果的一致性。【结果】本组185例患者,经官颈锥切术后组织病理学诊断检出宫颈低级别病率(LSIL)33例,HSIL^(+)152例,HSIL^(+)阳性率为82.16%(152/185);阴道镜阴性象限活检结果与宫颈锥切术后组织病理学诊断的一致率为72.43%,具有中度一致性(Kappa值为0.607);ECC检查结果与宫颈锥切术后组织病理学诊断的一致率为85.95%,具有高度一致性(Kappa值为0.799);TCT检查结果与宫颈锥切术后组织病理学诊断的一致率为80.00%,具有高度一致性(Kappa值为0.715);阴道镜阴性象限活检、ECC、TCT联合检查结果与宫颈锥切术后组织病理学诊断的一致率为94.59%,具有高度一致性(Kappa值为0.922)。【结论】阴道镜阴性象限活检、ECC及TCT均为诊断HSIL^(+)的可靠方法,3种方法联合检查有助于提高HSIL^(+)的检出率及诊断准确性。【Objective】To investigate the diagnostic value of colposcopy negative quadrant biopsy,cervical curettage(ECC)and liquid based thin layer cell assay(TCT)in high-grade cervical lesions(HSIL^(+)).【Methods】A total of 185 patients with abnormal pedestrian papillomavirus(HPV)screening in our hospital from March 2020 to March 2021 were selected as the research objects.They need to further undergo colposcopy negative quadrant biopsy,ECC and TCT.All patients underwent cervical conization for histopathological examination.Taking the histopathological examination results after cervical conization as the gold standard,the consistency between colposcopy negative quadrant biopsy,ECC,TCT alone and combined diagnosis of HSIL^(+) and pathological diagnosis was analyzed.【Results】Among 185 patients,33 cases of LSIL(CINI)and 152 cases of HSIL+were detected by histopathological diagnosis after cervical conization.The positive rate of HSIL^(+)was 82.16%(152/185);The coincidence rate between the results of colposcopy negative quadrant biopsy and histopathological diagnosis after cervical conization was 72.43%,with moderate consistency(Kappa value was 0.607);The coincidence rate between ECC and histopathological diagnosis after cervical conization was 85.95%(Kappa value 0.799);The coincidence rate between TCT and histopathological diagnosis after cervical conization was 80.00%,which was highly consistent(Kappa value was 0.715);The coincidence rate between the results of colposcopy negative quadrant biopsy,ECC and TCT and the histopathological diagnosis after cervical conization was 94.59%,which was highly consistent(Kappa value was 0.922).【Conclusion】Colposcopy negative quadrant biopsy,ECC and TCT are reliable methods for the diagnosis of HSIL^(+),and the combined examination of the three methods is helpful to improve the detection rate and diagnostic accuracy of HSIL+.

关 键 词：宫颈疾病/诊断 阴道镜检查 细胞学技术 

分 类 号：R711.74[医药卫生—妇产科学]