阴道镜联合宫颈活检在宫颈病变诊断中的意义

目的评价阴道镜联合宫颈活检在宫颈病变诊断中的意义。方法将2004年7月～2006年6月在我院就诊的247例宫颈病变患者随机分为阴道镜检查组（120例）与阴道镜联合宫颈活检组（127例），对两种检查方法宫颈上皮内瘤变（CIN）或宫颈癌的检出率及阴道镜图像与病理诊断结果进行比较。结果阴道镜检查组发现36例CIN或宫颈癌，检出率为30．0％；阴道镜联合宫颈活检组发现68例CIN或宫颈癌，检出率为53．5％。两种检查方法比较，差异有统计学意义（P〈0．05）。阴道镜联合宫颈活检组患者中，CINⅠ～Ⅲ中以糜烂、白色上皮发生率最高，其次是点状血管和镶嵌。CINI中宫颈糜烂发生率为81．3％，CINⅡ中宫颈糜烂发生率为88．9％，CINⅢ中宫颈糜烂发生率为83．3％，三者比较差异无统计学意义（P〉0．05）。结论阴道镜检查应注意血管异常、上皮的改变，必要时行阴道镜下常规活检，能及时发现宫颈癌和癌前病变，提高早期诊断率。

Significance of colposcopy and cervical biopsy in the diagnosis of cervical lesion

Objective To evaluate the significance of colposcopy and cervical biopsy in the diagnosis of cervical lesion. Methods All 247 patients with cervical lesion from July 2004 to June 2006 in our hospital were randomly divided into the colposcopy group （120 cases） and the colposcopy and cervical biopsy group （127 cases）. The detectable rate of cervical in traepithelial neoplasia （CIN） or cervical carcinoma of two inspection and the result of colposcopy and pathologic diagnosis were compared. Results There were 36 cases with CIN or cervical carcinoma in the colposcopy group and 68 cases in the colposcopy and cervical biopsy group. There were significant difference between two groups （P 〈 0.05）. The incidence rate of epithelium was highest among CIN Ⅰ to CIN Ⅲ. The incidence rate of cervical erosion in CIN Ⅰ was 81.3%, the inci- dence rate of cervical erosion in CIN Ⅱ was 88.9%, the incidence rate of cervical erosion in CIN Ⅲ was 83.3%. There was no significant difference among CIN Ⅰ to CIN Ⅲ（P 〉 0.05）. Conclusion Colposcopy must pay attention to the change of vascular anomaly and epithelium, and cervical biopsy is added when necessary, it can find cervical carcinoma and precan- cerous lesion in time, increase the early diagnosis rate.