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目的:探讨高危型HPV(HR-HPV)检测、细胞学检查、阴道镜检查在宫颈锥形电切术(LEEP)后的临床价值。方法:回顾性分析2010年3月～9月宫颈上皮内瘤变(CINⅡ/Ⅲ)患者,于宫颈锥形电切术后半年和1年,采用HR-HPV检测、细胞学检查、阴道镜检查,并进行随访,对三种检查方法中任何一种异常者均涂复方碘溶液后多点活检,分析三种方法随访的意义。结果:110例因宫颈CINⅡ-Ⅲ级患者行宫颈锥切术,其中资料完整随访至少1次的95例,阴道镜下宫颈多点活检33例,复发11例。HPV检测阳性12例中9例复发,细胞学检查阳性7例中5例复发,阴道镜检查阳性28例中10例复发。高危型HPV检测的准确性84.85%,特异性86.76%,阳性预测值75.00%,阴性预测值90.48%;细胞学检查的准确性75.76%,特异性90.90%,阳性预测值71.43%,阴性预测值76.92%;阴道镜检查的准确性42.42%,特异性18.18%,阳性预测值35.71%,阴性预测值80.00%。结论:检测宫颈CINⅡ/Ⅲ级患者行宫颈锥形电切术后复发率较低,高危型HPV检测准确性最高,细胞学检测次之,阴道镜检查较低。HCⅡ是宫颈锥形电切术后检测复发的重要指标。
Objective: To investigate the clinical value of high-risk HPV (HR-HPV), cytology and colposcopy after cervical cone tapping (LEEP). Methods: The clinical data of cervical intraepithelial neoplasia (CINⅡ / Ⅲ) from March to September in 2010 were analyzed retrospectively. HR-HPV, cytology and colposcopy , And were followed up on any of the three inspection methods were coated with iodine solution multi-point biopsy, the significance of follow-up analysis of three methods. Results: One hundred and one cases of cervical conization underwent cervical conization in patients with cervical CINⅡ-Ⅲ grade. Among them, 95 cases were followed up for at least one time with complete data, 33 cases were treated by colposcopy biopsy under colposcopy, and 11 cases were recurred. Of the 12 HPV positive cases, 9 were recurrent, 5 were recurrent in 7 cytology positive, and 10 were recurrent in 28 colposcopy positive. The accuracy of high-risk HPV test was 84.85%, specificity was 86.76%, positive predictive value was 75.00%, negative predictive value was 90.48%; cytological accuracy was 75.76%, specificity was 90.90%, positive predictive value was 71.43%, negative predictive value 76.92%; colposcopy accuracy 42.42%, specificity 18.18%, positive predictive value 35.71%, negative predictive value 80.00%. CONCLUSION: Cervical CINⅡ / Ⅲlevel patients have a lower recurrence rate after cervical conization, the high-risk HPV test has the highest accuracy, the second is cytology test and the colposcopy is lower. HC Ⅱ cervical conization is an important indicator of detection of recurrence.