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目的:探讨子宫颈癌术前临床检查与术后病理诊断结果的差异。方法:回顾性分析511例因子宫颈浸润癌而行广泛性子宫切除+盆腔淋巴结切除术患者的术前妇科检查、术中肉眼观察及术后病理检查情况,并对结果进行对比。结果:术前因妇科检查骶主韧带增厚增粗而诊断为Ⅱb期142例,而术后病理确诊者23例,阳性符合率为16.20%;术前妇科检查骶、主韧带阴性187例,但术后病理检查有浸润7例,阴性符合率96.26%;术前认为阴道穹窿阴性但术后病理阳性31例,阴性的符合率92.87%;术前考虑阴道穹窿受累但术后病理为阴性17例,阳性的符合率77.63%;术中因淋巴结肿大、质脆、粘连而诊断有淋巴结转移共299个,术后病理证实有转移的229个,阳性符合率76.59%,而认为淋巴结正常但病理诊断有转移54个。结论:宫颈癌的临床分期与术后病理结果确实存在差异,尤其体现在宫旁的诊断上。妇科检查与病理检查对宫旁的诊断阴性符合率较高,而阳性符合率低;对阴道穹窿的诊断阴性符合率亦较高,阳性符合率稍低;肉眼观察淋巴结有无转移是不够准确的。
Objective: To investigate the difference between preoperative clinical examination and postoperative pathological diagnosis of cervical cancer. Methods: A retrospective analysis of 511 cases of invasive cervical cancer due to radical hysterectomy + pelvic lymph node dissection in patients with preoperative gynecological examination, intraoperative visual and postoperative pathological examination, and the results were compared. Results: Preoperative gynecological examination of the sacral ligament thickening and thickening was diagnosed as stage Ⅱ b 142 cases, and postoperative pathological diagnosis of 23 cases, the positive coincidence rate was 16.20%; preoperative gynecological examination of the sacrum, the main ligament negative 187 cases, However, postoperative pathological examination had infiltration in 7 cases, negative coincidence rate of 96.26%; preoperative think vaginal fornix but postoperative pathological positive in 31 cases, the negative coincidence rate of 92.87%; preoperative consideration of vaginal vault involvement but postoperative pathology was negative 17 Cases, the positive coincidence rate of 77.63%; intraoperative diagnosis of lymph nodes due to swollen lymph nodes, crisp, adhesions and a total of 299, postoperative pathology confirmed the transfer of 229, the positive coincidence rate of 76.59%, and that the normal lymph nodes Pathological diagnosis of metastasis 54. Conclusion: The clinical stage of cervical cancer and postoperative pathological results do exist differences, especially in the diagnosis of the uterus. Gynecological examination and pathological examination of the palace next to the diagnosis of negative high coincidence, and the positive coincidence rate is low; the diagnosis of vaginal fornix negative coincidence rate is also higher, the positive coincidence rate slightly lower; macroscopic lymph node metastasis is not accurate enough .