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目的探讨阴道镜下对液基薄层细胞学检查(TCT)阳性患者进行宫颈定位活检在诊断宫颈上皮内瘤变(CIN)及宫颈癌中的应用价值。方法选取于2009年1月～2010年8月天津医科大学第二医院妇科门诊就诊的692例TCT阳性患者,对其进行分组观察。其中,388例作为观察组在阴道镜下定位活检,304例作为对照组行肉眼常规活检,比较两组CIN及宫颈癌的诊断率,并比较单纯TCT检查与结合阴道镜定位活检后,CIN及宫颈癌检出率。结果阴道镜下定位活检组与肉眼常规活检组CIN诊断率分别为64.18%、43.42%,两者比较差别有统计学差异(P<0.05);TCT结合阴道镜下定位活检后,CIN的检出率为64.18%,较单独TCT对CIN的检出率56.36%高,两者比较差别有统计学差异(P<0.05)。结论 TCT是一项宫颈疾病诊断中敏感性高的筛查手段,它结合阴道镜下定位活检能显著提高CIN及宫颈癌的检出率。这一方法对癌前病变、宫颈癌的诊断和筛查具有重要价值。
Objective To investigate the value of colposcopic biopsy in the diagnosis of cervical intraepithelial neoplasia (CIN) and cervical cancer by colposcopy in patients with positive TCT-positive smears. Methods From January 2009 to August 2010, 692 TCT positive patients in the gynecology outpatient department of the Second Hospital of Tianjin Medical University were selected and observed. Among them, 388 cases were treated as colposcopy biopsy under colposcopy and 304 cases were treated as biopsy by naked eye. The diagnostic rates of CIN and cervical cancer were compared between the two groups. Compared with pure colposcopy and colposcopy biopsy, CIN and Cervical cancer detection rate. Results The diagnostic rates of CIN in colposcopy-biopsy group and routine biopsy group were 64.18% and 43.42%, respectively (P <0.05). After TCT and colposcopy biopsy, the detection rate of CIN The rate of CIN was 64.18%, which was higher than that of TCT alone. The detection rate of CIN was 56.36%. There was significant difference between the two (P <0.05). Conclusion TCT is a highly sensitive screening method for cervical diseases. Combined with colposcopic biopsy, TCT can significantly improve the detection rate of CIN and cervical cancer. This method for the precancerous lesions, cervical cancer diagnosis and screening of great value.