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目的探讨阴道镜下多点活检与宫颈冷刀锥切对于宫颈上皮内瘤样病变Ⅲ级(CINⅢ)病理诊断的符合情况。方法1995~2005年间对北京大学人民医院92例阴道镜下多点活检病理诊断为CINⅢ的患者进行宫颈冷刀锥切治疗,比较阴道镜下多点活检与宫颈冷刀锥切的病理结果之间的差异。结果92例中有52例多点活检与冷刀锥切的病理结果一致,符合率为56.5%,40例多点活检与冷刀锥切的结果不同,其中11例多点活检诊断为CINⅡ/Ⅲ,而冷刀锥切诊断为微小浸润癌。结论宫颈锥切是宫颈上皮内瘤样病变的一种重要诊断与治疗方法。阴道镜下多点活检病理提示宫颈上皮内瘤样病变Ⅲ级并伴随腺体受累可能是存在宫颈浸润癌的一个高危因素。人乳头瘤病毒(HPV)感染与宫颈病变有关,但未发现HPV高危型检测数值高低与患者病理级别之间的联系。
Objective To investigate the coincidence of pathological diagnosis of cervical intraepithelial neoplasia III (CIN III) with colposcopic multi-point biopsy and cervical cold knife conization. Methods Between 1995 and 2005, 92 patients with CINIII underwent multi-point biopsy under the colposcope underwent cervical cold knife conization in the People’s Hospital of Peking University. The results were compared between the pathological results of colposcopic multi-point biopsy and cervical cold knife conization. The difference. Results The pathological results of 52 cases of multi-point biopsy and cold-knife conization were identical in 92 cases. The coincidence rate was 56.5%. The results of multi-point biopsy and cold-knife conization in 40 cases were different. Among them, 11 cases were diagnosed as CINII by multiple biopsy. III, and cold knife conization was diagnosed as microinvasive carcinoma. Conclusion Cervical conization is an important diagnostic and therapeutic method for cervical intraepithelial neoplasia. Colposcopic biopsy pathology suggests that grade III cervical intraepithelial neoplasia with involvement of the gland may be a risk factor for the presence of cervical invasive carcinoma. Human papillomavirus (HPV) infection has been associated with cervical lesions, but no association has been found between HPV high-risk test values and patient pathological grade.