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目的:评价阴道镜检查在宫颈癌筛查中的作用,探讨宫颈癌筛查的适宜技术,以有效提高宫颈癌前病变的检出率。方法:对2010～2011年苏州工业园区农村25 893例年龄35～65岁妇女行“三阶梯”式宫颈癌筛查,TCT细胞学结果阳性的受检者行阴道镜检察,并取活体组织行病理学检查,比较分析阴道镜在宫颈癌早期诊断的准确率及有效性。结果:25 893例受检者中TCT检查异常1 475例,进入第二阶段共1 351例行阴道镜检查,749例行组织活检病理检查,组织活检病理CINⅠ72例,CINⅡ88例,CINⅢ63例,宫颈癌3例。阴道镜拟诊断宫颈CINⅠ、CINⅡ和CINⅢ与组织病理诊断结果差异无统计学意义(P>0.05),二者吻合度差异有统计学意义(P<0.05)。结论:阴道镜检查可提高宫颈癌前病变检出率,是筛查宫颈癌前病变的重要手段。
Objective: To evaluate the role of colposcopy in cervical cancer screening and to explore suitable techniques for cervical cancer screening in order to effectively improve the detection rate of cervical precancerous lesions. Methods: A total of 25 893 women aged 35-65 years in Suzhou Industrial Park from 2010 to 2011 were screened for cervical cancer. The subjects with positive TCT cytology were examined by colposcopy and the living body Histopathological examination of the organization, comparative analysis of colposcopy in the early diagnosis of cervical cancer accuracy and effectiveness. Results: Totally 1 475 cases of TCT were abnormal in 25 893 subjects, 1 351 cases were colposcopy in the second stage, 749 cases were histopathologically examined, 72 cases of biopsy pathology, 88 cases of CIN Ⅱ, 63 cases of CIN Ⅲ, 3 cases of cancer. Colposcopy to diagnose cervical CIN Ⅰ, CIN Ⅱ and CIN Ⅲ and histopathological diagnosis showed no significant difference (P> 0.05), the difference between the two was statistically significant (P <0.05). Conclusion: Colposcopy can improve the detection rate of cervical precancerous lesions and is an important method to screen the precancerous lesions of cervical cancer.