阴道镜下多点活检联合ECC诊断绝经后CIN和宫颈癌的价值分析  

Value of Colposcopy Multi-point Biopsy Combined with ECC in the Diagnosis of Postmenopausal CIN and Cervical Cancer

作　　者：胡蕾蕾 吴东恩 张梅芳 陈芷菲 黄惠兰 林思华 朱珊珊 Hu Leilei;Wu Dongen;Zhang Meifang;Chen Zhifei;Huang Huilan;Lin Sihua;Zhu Shanshan(Department of Pathology,Heyuan City Maternal and Child Health Care Hospital,Heyuan 517000)

机构地区：[1]河源市妇幼保健院病理科,河源517000

出　　处：《数理医药学杂志》2022年第5期650-653,共4页Journal of Mathematical Medicine

基　　金：河源市科技计划项目(200728211506329)。

摘　　要：目的:探讨阴道镜下多点活检联合宫颈管搔刮术(ECC)诊断绝经后宫颈上皮内瘤变(CIN)和宫颈癌的价值。方法:纳入某院2019年7月-2021年3月期间198例因行宫颈细胞与人乳头状瘤病毒检查出现异常,现需进一步行阴道镜检查者,均对所有患者予以多点活检联合ECC检查及多点活检检查,以最终病理结果作为金标准,观察两组检验效能(阴性预测值、阳性预测值、灵敏度、准确度、特异度、误诊率),CIN与宫颈癌检测状况及一致性。结果:198例受检患者以病理结果为金标准,现确诊180例阳性,18例阴性,CINⅠ级患者20例,Ⅱ级85例,Ⅲ级63例,宫颈癌12例;多点活检联合ECC检查确诊178例阳性,20例阴性,Ⅰ级患者20例,Ⅱ级84例,Ⅲ级62例,宫颈癌12例;多点活检检查确诊172例阳性,26例阴性,Ⅰ级患者20例,Ⅱ级77例,Ⅲ级63例,宫颈癌12例。多点活检联合ECC检查阴性预测值(80.00%)、灵敏度(97.78%)、准确度(96.97%)显著高于多点活检检查(46.15%、92.22%、89.90%)(P<0.05),阳性预测值(98.88%)、特异度(88.89%)、误诊率(11.11%)与多点活检检查(96.51%、66.67%、33.33%)对比无统计学差异(P>0.05)。多点活检联合ECC检查CINⅡ级确诊人数(98.82%)高于多点活检检查组(90.59%)(P<0.05),两组Ⅰ级、Ⅲ级及宫颈癌确诊人数对比差异无统计学意义(P>0.05)。结论:阴道镜下多点活检联合ECC诊断绝经后CIN和宫颈癌的检验效能更好,对CINⅡ级检出率更高。Objective:To investigate the value of colposcopy multi-point biopsy combined with ECC in the diagnosis of postmenopausal CIN and cervical cancer.Methods:198 patients who needed further colposcopy due to abnormal cervical cells and human papillomavirus examination in a hospital from July 2019 to March 2021 were included.All patients were given multi-point biopsy combined with ECC and multi-point biopsy.The final pathological results were taken as the gold standard,the test efficacy(negative predictive value,positive predictive value,sensitivity,accuracy,specificity and misdiagnosis rate),the detection status and consistency of CIN and cervical cancer detection were observed.Results:Taken pathological results as the gold standard,among 198 patients,180 cases were diagnosed as positive,18 cases were diagnosed as negative,and there were 20 cases of CIN grade I,85 cases of grade II,63 cases of grade III and 12 cases of cervical cancer;172 cases were positive and 26 cases were negative confirmed by multi-point biopsy,and there were 20 cases of grade I,77 cases of grade II,63 cases of grade III and 12 cases of cervical cancer.The negative predictive value(80.00%),sensitivity(97.78%)and accuracy(96.97%)of multi-point biopsy combined with ECC were significantly higher than those of multi-point biopsy(46.15%,92.22%and 89.90%)(P<0.05).There was no significant difference in positive predictive value,specificity and misdiagnosis rate between multi-point biopsy combined with ECC(98.88%,88.89%,and 11.11%)and multi-point biopsy(96.51%,66.67%and 33.33%)(P>0.05).The number of patients diagnosed with CIN II by multi-point biopsy combined with ECC was 98.82%,higher than that by multi-point biopsy group(90.59%)(P<0.05).There was no significant difference in the number of patients diagnosed with grade I,III and cervical cancer between the two groups(P>0.05).Conclusion:Colposcopy multi-point biopsy combined with ECC is more effective in the diagnosis of postmenopausal CIN and cervical cancer,and the detection rate of CIN grade II is hi

关 键 词：多点活检 宫颈管搔刮术 宫颈上皮内瘤变 宫颈癌 绝经后 

分 类 号：R737.33[医药卫生—肿瘤]