不同宫颈转化区类型对阴道镜诊断宫颈上皮内瘤变准确性的影响  

Effect on the Accuracy by Colposcopy Among Different Cervical Conversion Area Types for the Patients of Cervical Intraepithelial Neoplasia

作　　者：李二雷 安国倩 邓宏文 刘冬梅 LI Er-lei;AN Guo-qian;DENG Hong-wen;LIU Dong-mei(Obstetrics and Gynecology Department of Hebei Yanda Hospital,Hebei Langfang 065201,China)

机构地区：[1]河北燕达医院妇产科,河北廊坊065201

出　　处：《循证医学》2022年第4期224-229,共6页The Journal of Evidence-Based Medicine

摘　　要：目的 探讨不同宫颈转化区类型对阴道镜诊断宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)准确性的影响。方法 选择2019年1月至2021年6月期间河北燕达医院妇产科宫颈癌筛查异常且实施阴道镜检查明确CIN患者586例作为研究对象。全部患者均采用阴道镜检查,以宫颈环形高频电刀切除(loop electrosurgical excision procedure,LEEP)手术后病理检查作为诊断金标准,计算阴道镜诊断CIN的灵敏度、特异度、阳性预测值、阴性预测值和符合率。结果 纳入的586例患者中,其中Ⅰ型315例,占53.75%,Ⅱ型170例,占29.01%,Ⅲ型101例,占17.24%。低度鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)158例,占26.96%,高度鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)428例,占73.04%。Ⅰ、Ⅱ型宫颈转化区患者以HSIL为主,而Ⅲ型宫颈转化区患者以LSIL为主,不同宫颈转化区比较差异具有统计学意义(P<0.05)。Ⅰ、Ⅱ、Ⅲ型宫颈转化区患者的宫颈癌发生率分别为7.62%(24/315)、7.06%(12/170)和3.96%(4/101),比较差异无统计学意义(χ^(2)=1.630,P=0.443)。不同宫颈转化区类型患者阴道镜检查诊断CIN的灵敏度、特异度、阳性预测值、阴性预测值和符合率比较差异具有统计学意义(P<0.05)。结论 宫颈转化区类型可能影响阴道镜诊断CIN准确性,以Ⅰ型宫颈转化区的诊断准确性最高,而Ⅲ型的最低。Objective To investigate the effect on the accuracy of colposcopy among different cervical conversion area types for the patients of cervical intraepithelial neoplasia(CIN). Methods 586 cases of CIN patients with abnormal cervical cancer screening identified by colposcopy from the Obstetrics and Gynecology Department of Hebei Yanda Hospital during the period of January 2019 to June 2021 were selected. Colposcopy was performed in all patients,and the sensitivity,specificity,positive predictive value,negative predictive value,and compliance rate of the colposcopy diagnosis for CIN were calculated. Results In 586 cases of CIN patients,including type Ⅰ of 315 cases,accounted for53.75%,type Ⅱ of 170 cases,accounting for 29.01%;type Ⅲ of 101 cases,accounting for 17.24%. And 158 cases of(low-grade squamous intraepithelial lesion,LSIL),accounting for 26.96%,and 428 cases of(low-grade squamous intraepithelial lesion,HSIL),accounting for 73.04%. HSIL were mainly in type Ⅰ,Ⅱ,and LSIL were mainly in type Ⅲ,compared among different cervical conversion types with statistical significance(P<0.05). But the rate of cervical cancer in type Ⅰ,Ⅱ,Ⅲ were respectively 7.62%(24/315),7.06%(12/170),and 3.96%(4/101),without different significance(χ^(2)=1.630,P=0.443),the sensitivity,specificity,positive predictive value,negative predictive value,and compliance rate by colposcopy for CIN compared among different cervical conversion types with statistical significance(P<0.05). Conclusions The cervical conversion area type may affect the accuracy of colposcopy for CIN,and the diagnosis accuracy of type Ⅰ was the highest,and type Ⅲ was the lowest.

关 键 词：宫颈上皮内瘤变 转化区类型 阴道镜 诊断 

分 类 号：R737.3[医药卫生—肿瘤]