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目的评价阴道镜联合LCT检查对宫颈病变诊断的临床意义。方法对潮州市中心医院2009年5月至2011年4月就诊的2077例患者进行液基细胞学技术检查(LCT),其中294例细胞学异常的患者进行阴道镜下活检和组织病理学诊断,并对结果进行分析。结果 294例中细胞学异常中ASCUS和ASC-H有96例,LSIL有135例,HSIL有59例,鳞癌4例。阴道镜发现异常206例,其中CINⅠ91例,CINⅡ51例,CINⅢ59例,鳞癌5例。宫颈活检病理结果炎症85例,CINⅠ86例,CINⅡ50例,CINⅢ67例,鳞癌6例。LCT对宫颈病变诊断的敏感性85.65%,特异性为77.65%。诊断符合率为83.33%。阴道镜对宫颈病变的诊断敏感性为91.87%,特异性为83.53%。诊断符合率为89.46%。阴道镜与LCT联合应用的敏感性为95.22%,特异性为94.12%,诊断符合率为94.90%。明显高于单独应用阴道镜或LCT。经χ2检验,P<0.05,具有统计学意义。结论定期进行阴道镜联合液基细胞学检查能提高宫颈病变的检出率。
Objective To evaluate the clinical significance of colposcopy combined with LCT in the diagnosis of cervical lesions. Methods Totally 2077 patients with LCT from May 2009 to April 2011 in Chaozhou Central Hospital were examined by colposcopy and histopathology. Of 294 patients with abnormal cytology, And analyze the result. Results There were 96 ASCUS and ASC-H cytological abnormalities in 294 cases, 135 cases of LSIL, 59 cases of HSIL and 4 cases of squamous cell carcinoma. Colposcopic abnormalities were found in 206 cases, of which 91 cases were CINⅠ, 51 cases were CINⅡ, 59 cases were CINⅢ and 5 cases were squamous cell carcinoma. Cervical biopsy results of inflammation in 85 cases, CIN Ⅰ 86 cases, CIN Ⅱ 50 cases, CIN Ⅲ 67 cases, squamous cell carcinoma in 6 cases. The sensitivity of LCT to diagnosis of cervical lesions was 85.65% and the specificity was 77.65%. The diagnostic coincidence rate was 83.33%. Colposcopy on the diagnosis of cervical lesions sensitivity was 91.87%, specificity was 83.53%. The diagnostic coincidence rate was 89.46%. Colposcopy and LCT combined application of the sensitivity was 95.22%, the specificity was 94.12%, the diagnostic coincidence rate was 94.90%. Significantly higher than with colposcopy alone or LCT. The χ2 test, P <0.05, with statistical significance. Conclusion Regular colposcopy liquid-based cytology can improve the detection rate of cervical lesions.