宫颈细胞学涂片联合阴道镜检查对宫颈病变的诊断价值

目的评价宫颈细胞学涂片联合阴道镜检查对宫颈病变的诊断价值。方法对2005-01~2006-12在哈尔滨医科大学附属第四医院妇科门诊检查的1 160例患者行宫颈细胞学涂片检查,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。结果宫颈涂片检查1 160例中,异常涂片146例(12.59%),临床高度可疑的患者40例行阴道镜检查下活检。病理结果显示:CINⅠ38例,CINⅡ8例,CINⅢ2例,子宫颈鳞癌2例。宫颈涂片细胞学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(P<0.05),两者联合病变检出率为98.0%。结论采用宫颈细胞学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。

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 undercolposcopy 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 1160 cases,146 cases(12.59%) were diagnosed as abnormal by cytologic smear.Results from pathologic examination shown that 2 cases with cervical squamous intraepithelial cancer,48 with cervical intraepithelial neoplasia(CIN) of which 38 cases of CINⅠ,8 cases of CINⅡ and 2 cases 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(P<0.05),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.