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目的探讨宫颈细胞学巴氏涂片配合阴道镜检查对农村妇女宫颈疾病筛查的价值。方法对2007年、2008年、2009年自愿参加体检者3886例行常规宫颈细胞学涂片检查,检出异常涂片391例,271例配合阴道镜检查,109例行肉眼碘试验活检为对照组,以组织学诊断为金标准,对结果进行分析。结果3886例涂片中检出异常涂片391例(10.06%),271例行阴道镜下活检,病理结果显示:宫颈上皮内瘤变(cer-vicalintra-epithelial neoplasia,CIN)诊断61例(22.51%),宫颈癌6例(2.21%)。巴氏Ⅲ级以上可疑病变35例,活检证实CIN25例与细胞学诊断符合率为71.43%,细胞学阴性临床可疑宫颈病变10例,活检证实CIN3例(30%)。109例肉眼碘试验下活检CIN诊断15例(13.76%),宫颈癌2例(1.83%),巴氏Ⅲ级以上30例活检证实CIN8例与细胞学诊断符合率为26.67%,细胞学阴性7例,CIN检出1例(14.29%)。两者比较,差异有显著性(P<0.05)。结论宫颈细胞学涂片配合阴道镜检查能及早发现宫颈癌前病变,是宫颈疾病筛查方便、安全、经济、可靠的检查方法,尤其适用于农村。
Objective To investigate the value of cervical cytology Pap smear with colposcopy in screening rural women for cervical diseases. Methods 3886 routine cervical cytology tests were performed on 3886 volunteers who volunteered to take physical examinations in 2007, 2008 and 2009, 391 cases of abnormal smears were detected, 271 cases were examined with colposcopy, 109 cases were examined with iodine biopsy , Histological diagnosis as the gold standard, the results were analyzed. Results A total of 3986 cases (10.06%) were detected in 3886 smears and 271 cases underwent vaginal biopsy. The pathological findings showed that 61 cases (22.51) were diagnosed by cervical intraepithelial neoplasia (CIN) %), Cervical cancer in 6 cases (2.21%). 35 cases of suspected grade Ⅲ or above Pap disease, biopsy confirmed 25 cases of CIN and cytology in line with the rate of 71.43%, negative cervical cytology clinical suspicious in 10 cases, biopsy confirmed CIN 3 cases (30%). In 109 cases of CIN, 15 cases (13.76%) were diagnosed by biopsy and 2 cases of cervical cancer (1.83%) by biopsy. The biopsy results of 30 cases with grade Ⅲ C or above showed that the coincidence rate of CIN in 8 cases was 26.67% with cytological diagnosis and negative in cytology Cases, CIN detected in 1 case (14.29%). The difference between the two was significant (P <0.05). Conclusion cervical cytology smears with colposcopy early detection of cervical precancerous lesions is a convenient screening of cervical disease, safe, economical and reliable inspection methods, especially for rural areas.