探讨阴道镜下活检诊断宫颈上皮内瘤样病变与宫颈锥切术后病理活检的符合率  

To Investigate the Coincidence Rate between Colposcopic Biopsy in Diagnosis of Cervical Intraepithelial Neoplasia and Pathological Biopsy after Cervical Conectomy

作　　者：张国辉 姚凉凤 柯桂珠 ZHANG Guohui;YAO Liangfeng;KE Guizhu(Department of Gynecology,Zhangzhou Municipal Hospital of Fujian Province,Zhangzhou 363000,China)

机构地区：[1]福建省漳州市医院妇科,福建漳州363000

出　　处：《中国医药指南》2023年第27期89-91,共3页Guide of China Medicine

摘　　要：目的探讨阴道镜下活检诊断宫颈上皮内瘤样病变与宫颈锥切术后病理活检的符合率。方法将2021年9月至2022年9月于福建省漳州市医院进行阴道镜下活检诊断为宫颈上皮内瘤样病变的125例患者纳入研究,所有患者均行宫颈锥切术,比较阴道镜下活检诊断结果与术后病理诊断结果。结果阴道镜下活检诊断结果显示,125例患者中有宫颈上皮内瘤样病变Ⅰ级25例,Ⅱ级58例,Ⅲ级42例(含宫颈原位癌12例)。宫颈锥切术后病理活检结果显示,125例患者中,有10例慢性宫颈炎,宫颈上皮内瘤样病变Ⅰ级18例,Ⅱ级50例,Ⅲ级45例(含宫颈原位癌15例),早期浸润癌与浸润癌各1例。阴道镜下活检诊断宫颈上皮内瘤样病变与宫颈锥切术后病理活检的符合率为75.20%(94/125),阴道镜下活检诊断宫颈上皮内瘤样Ⅲ级病变与宫颈锥切术后病理活检的符合率为83.33%(35/42),较Ⅰ级、Ⅱ级病变的64.00%(16/25)、74.14%(43/58)高,但其差异无统计学意义(P>0.05)。结论阴道镜下活检能够有效诊断宫颈上皮内瘤样病变,并对其进行分级,对于Ⅲ级病变的诊断符合率较高,但是,该检查方式取材有限,容易出现漏诊、误诊情况,因此,为进一步提高诊断符合率,需要开展宫颈锥切术,以获取足够病理组织,优化临床诊断。Objective To investigate the coincidence rate between colposcopic biopsy in the diagnosis of cervical intraepithelial neoplasia and pathological biopsy after cervical conectomy.Methods A total of 125 patients diagnosed with cervical intraepithelial neoplasia by colposcopic biopsy in Zhangzhou Municipal Hospital of Fujian Province from September 2021 to September 2022 were included in the study.All patients underwent cervical conotomy.The results of colposcopic biopsy and postoperative pathological diagnosis were compared.Results The colposcopic biopsy showed that there were 25 cases of grade Ⅰ,58 cases of grade Ⅱ,42 cases of grade Ⅲ(including 12 cases of cervical carcinoma in situ).Pathological biopsy results showed that among the 125 patients,there were 10 cases of chronic cervicitis,18 cases of cervical intraepithelial neoplasia grade Ⅰ,50 cases of grade Ⅱ,45 cases of grade Ⅲ(including 15 cases of cervical carcinoma in situ),and 1 case of early invasive carcinoma and 1 case of invasive carcinoma.The coincidence rate of colposcopic biopsy for diagnosis of cervical intraepithelial neoplasia was 75.20%(94/125),and the coincidence rate of colposcopic biopsy for diagnosis of cervical intraepithelial neoplasia grade Ⅲ lesions was 83.33%(35/42).It was higher than 64.00%(16/25)and 74.14%(43/58)of grade Ⅰ and Ⅱ lesions,but the difference was not statistically significant(P>0.05).Conclusion Colposcopic biopsy can effectively diagnose cervical intraepithelial neoplasia and grade it.For grade Ⅲ lesions,the diagnosis coincidence rate is high.However,this examination method has limited materials,and is prone to missed diagnosis and misdiagnosis.

关 键 词：阴道镜 活检诊断 宫颈上皮内瘤样病变 宫颈锥切术 病理诊断 

分 类 号：R711.74[医药卫生—妇产科学] R737.33[医药卫生—临床医学]