阴道镜检查在宫颈病变诊断中的临床价值

目的]探讨阴道镜检查在宫颈病变诊断中的临床价值.方法]2007年6月至2009年6月诊治275例宫颈病变患者,对其宫颈阴道镜及镜下活检结果进行分析.结果]经病理确诊为慢性宫颈炎221例,宫颈上皮内瘤变（CIN） 39例 （CIN Ⅰ10例、CINⅡ16例、CIN Ⅲ13例）,宫颈癌15例.阴道镜检查对CIN的灵敏度为69%,特异度为94%,阳性预测值为64.3%,阴性预测值为94.8%,阳性似然比为10.89,阴性似然比为0.33,诊断符合率为90.18%.阴道镜检查对宫颈癌的灵敏度为67%,特异度为98%,阳性预测值为71.4%,阴性预测值为98.1%,阳性似然比为43.33,阴性似然比为0.34,诊断符合率为96.73%.结论]阴道镜检查对宫颈癌尤其是癌前病变的早期诊断有重要的临床价值.

Clinical Value of Colposcopy in the Diagnosis of Cervical Lesions

Objective] To explore the clinical value of colposcopy in the diagnosis of cervical lesions. Methods]From June 2007 to June 2009, colposcopy inspection and biopsy results were used to analyze 275 cases of cervical lesions. Resultsl About 221 cases of chronic cervicitis, 39 cases of cervical intraepithelial neoplasia（CIN）（CIN Ⅰ 10, CIN Ⅱ 16 and CIN Ⅲ 13, respectively） and 15 cases of cervical cancer were confirmed by pathology. The sensitivity and specificity of colposcopy for CIN was 69% and 94 %, respectively, and the positive and negative predictive value was 64.3% and 94.8%, respectively, and the positive and negative likelihood ratio was 10.89 and 0.33, respectively, and the diagnose accordance rate was 90. 18%. The sensitivity and specificity of colposcopy for cervical cancer was 67 % and 98%, respectively, and the positive and negative predictive value was 71.4% and 98.1 %, respectively, and the positive and negative likelihood ratio was 43.33 and 0.34, respectively, and the diagnose accordance rate was 96.73%. Conclusion]Colposcopy has an important value for the early diagnosis of cervical cancer, especially for precancerous lesion.