阴道镜图像对宫颈疾病的诊断价值

目的　评价阴道镜图像对宫颈疾病尤其对宫颈上皮内瘤样病变 (CIN)的诊断价值。方法　 2 0 0 3年 4月至 2 0 0 4年 3月上海市黄浦区中心医院对 2 4 0例患者进行阴道镜检查 ,根据阴道镜图像定位取活组织送病理检查。结果　根据阴道镜拟诊与组织病理学结果进行对照 ,完全符合率是 6 1 2 5 %,包括相差一个级别在内者符合率为 95 %。对CIN诊断敏感性为 84 31 %、特异性 6 2 43%、阳性预测值 37 72 %、阴性预测值 93 6 5 %。结论　阴道镜图像对应阴道镜拟诊与组织病理学有较高的符合率 ,对CIN的诊断价值在于敏感性和阴性预测值高的优点 ,适合作为CIN的筛查方法。

Evaluation of colposcopy picture in the diagnosis of cervical disease

Objective To evaluate the value of colposcopy picture in the diagnosis of cervical disease, especially the cervical intraepithelial neoplasia(CIN). Methods Colposcopic inspections and biopsies were performed on 240 women between April 2003 and March 2004 in Shanghai Huang pu Central Hospital . Results Comparing colposcopic diagnosis with pathological outcome,coincidence rate was 61.25%;including one grade deviation,the coincidence rate was 95%.While the sensitivity in diagnosis of CIN was 84.31%,specificity was 62.43%,positive predictive value was 37.72% and negative predictive value was 93.65%. Conclusion Colposcopic diagnosis has a high coincidence rate with biopsy.The value of colposcopy in diagnosis of CIN was its high sensitivity and negative predictive value.Colposcopy is suitable for CIN screening.