论文部分内容阅读
目的:评价阴道镜在宫颈上皮内瘤变(CIN)诊断中应用价值。方法:回顾性分析2009年以来阴道镜下宫颈组织活检病理诊断为各级CIN的患者共计182例,比较其Reid评分、阴道镜下图像和病理结果。结果:以组织病理学诊断为标准,①Reid评分诊断癌前病变的符合率为79.67%,高估诊断的误差率为9.34%,低估诊断的误差率为10.99%,诊断宫颈低度病变(即CINⅠ)的敏感性为79.52%,诊断宫颈高度病变(即CINⅡ+CINⅢ)的敏感性为90.91%。②阴道镜评价诊断癌前病变的符合率为46.15%,高估诊断的误差率为26.92%,低估诊断的误差率为26.92%,阴道镜诊断宫颈低度病变(即CINⅠ)的敏感性为50.60%,诊断宫颈高度病变(即CINⅡ+CINⅢ)的敏感性为75.76%。结论:阴道镜在宫颈上皮内瘤变的诊断中具有重要的临床应用价值,Reid评分系统有助于阴道镜下更准确的判断宫颈癌前病变的性质。阴道镜下多点活检并适时进行ECC和LEEP,遵循三阶梯技术,可以弥补阴道镜假阴性的疏漏。
Objective: To evaluate the value of colposcopy in the diagnosis of cervical intraepithelial neoplasia (CIN). Methods: A retrospective analysis of the total number of patients with CIN diagnosed by colposcopic biopsy under colposcopy since 2009 was performed. A total of 182 patients were enrolled, and their Reid scores, colposcopic images and pathological findings were compared. Results: According to the histopathological diagnosis, the coincidence rate of Reid score in diagnosing precancerous lesion was 79.67%, the error rate in overestimation was 9.34%, and the error rate in underestimation was 10.99%. The diagnosis of cervical lesion (ie, CINⅠ ) Was 79.52%. The sensitivity of diagnosing cervical lesions (CINⅡ + CINⅢ) was 90.91%. ② The coincidence rate of colposcopy in the diagnosis of precancerous lesions was 46.15%, the error rate of over-estimation diagnosis was 26.92%, the error rate of underestimation diagnosis was 26.92%. The sensitivity of colposcopy in diagnosing cervical low-grade lesions (CINⅠ) was 50.60 %, The diagnosis of cervical lesions (ie CIN Ⅱ CIN Ⅲ) sensitivity was 75.76%. CONCLUSION: Colposcopy has important clinical value in the diagnosis of cervical intraepithelial neoplasia. Reid scoring system can help colposcope to determine more accurately the nature of cervical precancerous lesions. Colposcopy multi-point biopsy and timely ECC and LEEP, follow the three ladder technology, you can make up for colposcopy false negative omissions.