阴道镜检查联合液基细胞学(TCT)检查对宫颈癌早期病变阳性检出率的影响  

To investigate the effect of colposcopy combined with liquid-based cytology(TCT)on the positive detection rate of early cervical cancer

作　　者：王真真 兰银晓 焦叶林 Wang Zhenzhen;Lan Yinxiao;Jiao Yelin(The First People's Hospital of Luoyang,Henan Luoyang 471000)

机构地区：[1]洛阳市第一人民医院,河南洛阳471000

出　　处：《辽宁医学杂志》2025年第1期18-21,共4页Medical Journal of Liaoning

基　　金：河南省医学科技攻关联合共建项目(LHGJ20221010)。

摘　　要：目的探究阴道镜、液基细胞学(TCT)检查在宫颈癌早期病变阳性检出率中的临床应用价值,以期为临床选择治疗方案、改善患者生活质量提供参考依据。方法选取138例于2022年4月—2023年7月在本院行宫颈癌筛查者作为研究对象,以病理组织学结果为金标准,比较分析阴道镜、TCT单独及联合诊断宫颈癌早期病变结果,分析不同检查方式的一致性。结果TCT联合阴道镜诊断结果与病理组织学结果一致性Kappa为0.869,95%CI为0.675~1.062,符合率0.917,均高于单独诊断,具有较高的一致性;TCT、阴道镜联合诊断宫颈癌前病变的灵敏度、准确度为97.83%、97.10%,均高于单独诊断,漏诊率2.17%低于单独诊断(P<0.05);相较于单独诊断,TCT联合阴道镜诊断对宫颈癌、宫颈炎及癌前病变的检出率均较高(P<0.05)。结论TCT联合阴道镜诊断在宫颈癌早期病变中的灵敏度较高,漏诊率较低,在诊断不同类型早期病变中与金标准结果具有较高一致性,有助于提高治疗及时性、延长患者生存期限、降低死亡率。Objective To explore the clinical application value of colposcopy and liquid-based cytology(TCT)examination in the detection rate of early cervical cancer lesions,in order to provide reference for clinical selection of treatment options and improve the quality of life of patients.Methods A total of 138 patients who underwent cervical cancer screening in our hospital from April 2022 to July 2023 were selected as the research objects.With histopathological results as the gold standard,the results of colposcopy,TCT alone and combined diagnosis of early cervical cancer were compared and analyzed,and the consistency of different examination methods was analyzed.Results The Kappa value of TCT combined with colposcopy was 0.869,95%CI was 0.675~1.062,and the coincidence rate was 0.917,which was higher than that of single diagnosis.The sensitivity and accuracy of TCT combined with colposcopy in the diagnosis of cervical precancerous lesions were 97.83%and 97.10%,which were higher than those of single diagnosis,and the missed diagnosis rate was 2.17%,which was lower than that of single diagnosis(P<0.05).Compared with single diagnosis,the detection rate of TCT combined with colposcopy in the diagnosis of cervical cancer,cervicitis and precancerous lesions was higher(P<0.05).Conclusion TCT combined with colposcopy has high sensitivity and low missed diagnosis rate in the diagnosis of early-stage cervical cancer,and has high consistency with the gold standard results in the diagnosis of different types of early-stage cervical cancer,which is helpful to improve the treatment timeliness,prolong the survival time of patients,and reduce the mortality.

关 键 词：阴道镜 液基细胞学 宫颈癌 早期病变 阳性检出率 

分 类 号：R73[医药卫生—肿瘤]