薄层液基细胞学制片联合阴道镜检查对宫颈病变的诊断价值

目的评价薄层液基细胞学制片联合阴道镜检查对宫颈病变的诊断价值。方法对2006年1月～2008年12月在哈尔滨医科大学附属第四医院妇科门诊检查的1220例患者行宫颈薄层液基细胞学制片(TCT)检查,对其中186例细胞学提示阳性或临床高度可疑的患者行阴道镜下活组织病理检查,以病理诊断为金标准,对结果进行分析。结果宫颈薄层液基细胞学制片检查1220例中,异常涂片157例(12.59%),临床高度可疑的患者45例行阴道镜检查下活检。病理结果显示:CINⅠ39例,CINⅡ9例,CINⅢ3例,子宫颈鳞癌3例。TCT检查诊断宫颈病变符合率为84.0%,阴道镜检查对宫颈病变的诊断符合率为88.0%,两者比较差异具有显著性(P0.05),二者联合病变检出率为98.0%。结论采用薄层液基细胞学制片检查配合阴道镜下病理检查可明显提高对宫颈病变诊断的准确率,能满足早期发现癌前病变的需要。

Use and significance of cytologic examination of cervical smear combined with biopsy under colposcopy to diagnose cervical squamous intraepithelial lesions.

Objective：To evaluate the effects of cytologic examination of cervical smear combined with biopsy under colposcopy in diagnosis of cervical squamous intraepithelial lesions.Methods：From January 2005 to December 2006,there were 1160 women accepting the screening for cervical lesion by cytologic smear combined with biopsy under colposcopy in the fourth hospital of Harbin medical university.Pathologic examization of biopsy under colposcopy was assumed as ＂goldstandard＂.Results：Among 1220cases,157cases（12.59%） were diagnosed as abnormal by cytologic smear.Results：From pathologic examination shown that 2 cases with cervical squamous intraepithelial cancer,45 with cervical intraepithelial neoplasia（CIN） of which 39 cases of CINⅠ,9 cases of CINⅡ and 3cases of CINⅢ,Coincident rate of diagnosing CIN was 84.0% and 88.0% for cytologic examination of cervical smear and for colposcopy examination,the difference of coincident rates was statistically significant（P0.05）,combined rate was 98.0%.Conclusion：Cytologic examination of cervical smear combined with biopsy under colposcopy are recommended to be as routine screening to identify precancerous lesions.