阴道镜下宫颈活检对宫颈上皮内瘤变的诊断价值探讨  

Diagnostic value of cervical biopsy under colposcopy for cervical intraepithelial neoplasia

作　　者：黎卓涵 金海鸿 艾春玲 蔡娱飞[4] LI Zhuo-han;JIN Haihong;AI Chun-ling(Beihua University,Jilin Jilin 132013,China;Changchun University of Traditional Chinese Medicine Affiliated Third Clinical Hospital;Jilin University of Traditional Chinese Medicine Affiliated First Clinical Hospital)

机构地区：[1]北华大学,吉林吉林132013 [2]长春中医药大学附属第三临床医院 [3]吉林省中医药科学院第一临床医院 [4]北华大学附属医院

出　　处：《中国实验诊断学》2023年第1期40-44,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的 探讨HPV、TCT联合阴道镜及阴道镜下宫颈活检对宫颈上皮内瘤变(CIN)的诊断价值。方法 回顾性分析长春中医药大学附属第三临床医院妇科门诊行宫颈筛查中发现薄层液基细胞学检查(TCT)或HPV E6/E7 mRNA检查异常以及临床诊断怀疑存在宫颈病变需转诊阴道镜检查的198例患者,并行阴道镜图像拟诊断与组织病理学诊断,研究比较各项检查结果,评价HPV、TCT以及阴道镜检查对于早期诊断宫颈癌的效果。结果 18~39岁患者诊断宫颈上皮内瘤变人数最多。经组织病理学诊断宫颈上皮内瘤变(阳性)166例;经阴道镜图像拟诊断宫颈上皮内瘤变(阳性)145例,差异有统计学意义(P<0.05),阴道镜图像拟诊断准确率为73.2%。联合采用TCT和HPV E6/E7 mRNA诊断的灵敏度最高,较单一诊断相比,检出率显著升高,χ^(2)值分别为63.616,15.602,P值分别为0.000,0.000。结论 CIN的发病年龄逐步年轻化,应提高年轻人的筛查意识。阴道镜图像拟诊断对宫颈上皮内瘤变的检出准确率较高,在CIN患者临床筛查中使用阴道镜检查实用性高,能为疾病诊治提供可靠信息,值得采纳。Objective To investigate the diagnostic value of HPV,TCT combined with colposcopy and cervical biopsy under colposcopy in cervical intraepithelial neoplasia(CIN).Methods Retrospective analysis was made on 198 patients who were found abnormal thin layer liquid based cytology(TCT) or HPV E6/E7 mRNA during cervical screening in the gynaecological clinic of the Third Affiliated Clinical Hospital of Changchun University of Traditional Chinese Medicine in Jilin Province, and who were suspected of having cervical diseases and needed to be referred to colposcopy in clinical diagnosis.The colposcopy image was proposed to be diagnosed and the pathological diagnosis of cervical biopsy was made.The results of various examinations were studied and compared, and HPV The effect of TCT and colposcopy on early diagnosis of cervical cancer.Results The number of patients aged 18 to 39 years diagnosed with cervical intraepithelial neoplasia was the largest.166 cases of cervical intraepithelial neoplasia(positive) were diagnosed by histopathology;145 cases of cervical intraepithelial neoplasia(positive) were diagnosed by colposcopy image, the difference was statistically significant(P<0.05).The accuracy of colposcopy image diagnosis was 73.2%.The combination of TCT and HPV E6/E7 mRNA has the highest sensitivity, and the detection rate is significantly higher than that of single diagnosis, The χ^(2) values are 63.616 and 15.602 respectively, and the P values are 0.000 and 0.000 respectively.Conclusion The onset age of CIN is gradually younger, and the screening awareness of young people should be improved.The colposcopy image intended diagnosis has a high detection accuracy rate for cervical intraepithelial neoplasia, and the colposcopy examination is highly practical in clinical screening of CIN patients, which can provide reliable information for disease diagnosis and treatment, and is worth adopting.

关 键 词：阴道镜 宫颈活检 宫颈上皮内瘤变 诊断价值 回顾性研究 

分 类 号：R737.33[医药卫生—肿瘤]