宫颈上皮内瘤变诊断方法的比较

目的:进一步评价细胞学、阴道镜和组织病理学在宫颈病变诊断中的临床意义。方法:收集2004年1月~2005年12月福建医科大学附属第一医院537例宫颈病变患者的临床资料进行分析研究。结果:537例宫颈病变,直接阴道镜检查及病理组织学诊断CIN、宫颈癌占250例,发生率46.55%。其中217例宫颈液基薄层细胞学检查(TCT)配合阴道镜检查及组织学病理诊断CIN及宫颈癌发生率47.92%,TCT报告在ASCUS级别以上(包括LSIL、HSIL)阴道镜检及组织学病理诊断CIN及宫颈癌发生率66.37%,二者有显著差异。结论:TCT、阴道镜检查、组织病理学检查三个手段是诊断宫颈病变的常用方法,联合应用能显著提高宫颈上皮内瘤变的诊断水平。TCT是宫颈上皮内瘤变早期诊断首选筛查方法。

Comparison of the Diagnostic Methods of Cervical Intraepithelial Neoplasia

Objective: To evaluate the clinical value of the usage of cytology,colposcopy and histopathology in diagnosis of cervical lesions.Methods: From January,2004 to December,2005,the clinical data of 537 patiens of cervical lesions were studied.Results: Among 537 cases,250 were diagnosed as cervical intraepithelial neoplasia(CIN) or cervical cancer by colposcopy and histopathology.The incidence was 46.55%.217 cases were diagnosed as CIN or cervical cancer by the combination usage of thinprep cytologic test(TCT),colposcopy and histopathology.The incidence was 47.92%.The grade above ASCUS(including LSIL and HSIL)through TCT were diagnosed as CIN or cervical cancer by colposcopy or histopathology,which incidence was 66.37%(P<0.05).Conclusion: TCT,colposcopy and pathohistology are common methods for the diagnosis of cervical lesions,the combination usage of them can improve the diagnosis rate of CIN.TCT is the capital method for CIN screening.