阴道镜用于筛查宫颈癌前病变的价值研究  

The value of colposcopy in screening cervical precancerous lesions

作　　者：陈哲 刘文静[1] 王涛[1] CHEN Zhe;LIU Wen-jing;WANG Tao(Affiliated Hospital of Binzhou Medical College,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院,256603

出　　处：《中国实用医药》2022年第15期92-94,共3页China Practical Medicine

摘　　要：目的 分析宫颈癌前病变筛查中使用阴道镜检查的临床价值。方法 160例疑似宫颈癌患者作为研究对象,均经过宫颈液基细胞学检查、阴道镜检查及活检、宫颈环形电切术(LEEP)。以LEEP术后病理结果为金标准,观察术前阴道镜检查及活检结果。结果 160例患者经过LEEP术后病理结果证实为CINⅡ~Ⅲ级,以此为金标准,诊断降级率为10.00%(16/160),诊断升级率为23.75%(38/160),术前阴道镜检查及活检结果符合率为66.25%(106/160)。阴道镜检查显示:104例患者呈现暴露充分的Ⅰ型转化区,与LEEP术后病理结果符合率为77.88%(81/104),病理诊断升级率为13.46%(14/104),病理诊断降级率为8.65%(9/104)。56例患者呈暴露不充分的Ⅱ、Ⅲ型转化区,与LEEP术后病理结果符合率为44.64%(25/56),病理诊断升级率为42.86%(24/56),病理诊断降级率为12.50%(7/56)。结论 在筛查宫颈癌前病变时,应通过阴道镜对转化区类型进行评估,然后再决定活检方式,如果转化区为Ⅱ、Ⅲ型,则可以直接利用宫颈管搔刮术、诊断性LEEP术对宫颈管内病变进行排除。Objective To analyze the clinical value of colposcopy in screening cervical precancerous lesions.Methods A total of 160 patients with suspected cervical cancer were selected as the research subjects,and they all underwent cervical liquid-based cytology,colposcopy and biopsy,and loop electrosurgical excision(LEEP).The pathological findings after LEEP were used as the gold standard to observe the results of preoperative colposcopy and biopsy.Results The pathological results of 160 subjects were confirmed to be CIN gradeⅡ-Ⅲafter LEEP,which was used as the gold standard,with a diagnostic downgrade rate of 10.00%(16/160),a diagnostic upgrade rate of 23.75%(38/160),and a compliance rate of preoperative colposcopy and biopsy results of 66.25%(106/160).Colposcopy test results:104 subjects presented an adequately exposed typeⅠtransformation zone,and the compliance rate with the pathological findings after LEEP was 77.88%(81/104),the pathological diagnosis upgrade rate was 13.46%(14/104),and the pathological diagnosis downgrade rate was 8.65%(9/104);56 cases showed an inadequately exposed typeⅡandⅢtransformation zone,and the compliance rate with the pathological findings after LEEP was 44.64%(25/56),the pathological diagnosis upgrade rate was 42.86%(24/56),and the pathological diagnosis downgrade rate was 12.50%(7/56).Conclusion When screening for cervical precancerous lesions,the type of transformation zone should be evaluated by colposcopy before deciding on the biopsy modality.If the transformation zone is typeⅡorⅢ,the lesions in the cervical canal can be excluded directly using cervical canal scratching and targeted LEEP.

关 键 词：阴道镜 筛查 宫颈癌 宫颈活检 转化区 诊断价值 

分 类 号：R737.33[医药卫生—肿瘤]