阴道镜在子宫颈病变诊断中的应用价值

目的:探讨影视阴道镜在子宫颈疾病诊断中的临床意义。方法:回顾性分析280例宫颈细胞学异常患者(其中ASC-US30例、LSIL192例、HSIL58例),阴道镜下行多点活检明确组织学诊断,252例合并有高危HPV病毒阳性(90.0%),9例为低危HPV病毒阳性(3.2%)。结果:本组阴道镜柱状上皮外移及慢性宫颈炎症64例,SPI和CINⅠ共116例,尖锐湿疣5例,CINⅡ～Ⅲ共80例,宫颈浸润癌15例。所有标本均经组织病理学检查,确诊为柱状上皮外移及慢性宫颈炎症61例,SPI和CINⅠ109例,尖锐湿疣4例,CINⅡ～Ⅲ73例,浸润癌14例,阴道镜诊断与组织病理学检查诊断符合率依次为95.3%、93.9%、80.0%、91.3%和93.3%,阴道镜诊断符合率达93.2%(261/280)。结论:影视阴道镜检查准确、可靠,对早期宫颈癌具有重要的诊断价值,提高了子宫颈病变诊断精确度。

Application value of colposcope in diagnosis of cervical lesions

Objective:To explore the clinical significance of colposcope in diagnosis of cervical lesions.Methods:280 cases with abnormal cervical cytological results (including 30 cases with ASCUS, 192 cases with LSIL and 58 cases with HSIL) received multiple biopsies under colposcope to define histological diagnosis, 252 cases were combined with positive high risk HPV (90.0%), 9 cases were combined with positive low risk HPV (3.2%).Results:Colposcopic diagnosis: 64 cases were diagnosed as immigration of columnar epithelium and chronic cervical inflammation, 116 cases were diagnosed as SPI and CIN Ⅰ, 5 cases were diagnosed as condyloma acuminatum, 80 cases were diagnosed as CIN Ⅱ-Ⅲ, 15 cases were diagnosed as cervical invasive cancer, all the samples received pathological examination. Pathological diagnosis: 61 cases were diagnosed as immigration of columnar epithelium and chronic cervical inflammation, 109 cases were diagnosed as SPI and CIN Ⅰ, 4 cases were diagnosed as condyloma acuminatum, 73 cases were diagnosed as CIN Ⅱ-Ⅲ, 14 cases were diagnosed as cervical invasive cancer, the coincidence rate of colposcopic diagnosis and histopathological diagnosis was 95.3%, 93.9%, 80.0%, 91.3% and 93.3%; the coincidence rate of colposcopic diagnosis was 93.2% (261/280).Conclusion:Colposcopy is accurate and reliable, which has important value for early cervical cancer and can improve the accuracy of diagnosis of cervical lesions.