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目的评价国产电子阴道镜(型号JY2650)与光学阴道镜(型号YDJ99046)在宫颈上皮内瘤变(CIN)及人乳头瘤病毒(HPV)亚临床感染(SPI)诊断中的应用价值及临床意义。方法选择2005年7月至2006年1月昆明市延安医院妇产科收治的阴道镜及细胞学检查异常患者290例,同时应用国产电子阴道镜和光学阴道镜检查诊断,根据阴道镜图像定位取活检,均有病理诊断结果,对其进行对比研究。结果二者在CIN各级中的比较:(1)CINⅠ级:阴性预测、阳性预测及敏感性二者间差异有显著性意义(P<0·05)。(2)CINⅡ级:阴性预测与阳性预测差异有显著性意义(P<0·05)。(3)CINⅢ级:阴性预测和阳性预测二者间差异有显著性意义(P<0·05)。在SPI中的比较:阴性预测和阳性预测二者间差异有极显著性意义(P<0·01),敏感性差异有极显著性意义(P<0·01)。结论在CIN和SPI的临床诊断中,电子阴道镜的阴性预测值高;光学阴道镜的阳性预测值高、敏感性高;特异性两者相同。电子阴道镜在资料储存、随访、教学、科研中有一定可行性和实用性,优于光学阴道镜;而光学阴道镜阳性预测值高、敏感性高,对早期微小病灶的分辨优于电子阴道镜。
Objective To evaluate the value and clinical significance of the domestic electronic colposcopy (JY2650) and optical colposcopy (model YDJ99046) in the diagnosis of cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) subclinical infection (SPI). Methods From July 2005 to January 2006, Kunming Yan’an Hospital Obstetrics and Gynecology admitted to colposcopy and cytology abnormalities in 290 patients, at the same time using domestic electronic colposcopy and optical colposcopy diagnosis, according to colposcopy image positioning Biopsy, both pathological diagnosis, its comparative study. Results CIN levels at both levels: (1) CIN Ⅰ level: negative predictive value, positive predictive value and sensitivity between the two significant differences (P <0.05). (2) CINⅡlevel: There was a significant difference between negative predictive value and positive predictive value (P <0.05). (3) CIN Ⅲ level: There was significant difference between negative predictive value and positive predictive value (P <0.05). Comparison in SPI: There was a significant difference between negative predictive value and positive predictive value (P <0.01), and there was significant difference in sensitivity (P <0.01). Conclusions In the clinical diagnosis of CIN and SPI, the negative predictive value of electron colposcopy is high. The positive predictive value of optical colposcopy is high and the sensitivity is high. The specificity is the same between the two. Electronic colposcopy in data storage, follow-up, teaching, scientific research has a certain feasibility and practicality, better than optical colposcopy; and ophthalmic colposcopy positive predictive value, high sensitivity, the resolution of early micro-lesions is superior to the electronic vagina mirror.