發(fā)布時間：2018-03-08 14:35

  本文選題：宮頸上皮內(nèi)瘤變　切入點(diǎn)：宮頸癌　出處：《中國老年學(xué)雜志》2017年12期 　論文類型：期刊論文

【摘要】：目的探討陰道鏡指引下多點(diǎn)活檢檢測早期子宮頸癌的臨床效果。方法 412例人乳頭瘤病毒(HPV)檢測及宮頸細(xì)胞學(xué)檢測異常的患者,行陰道鏡指引下多點(diǎn)活檢及子宮頸環(huán)形電切術(shù)(LEEP),回顧性分析患者LEEP手術(shù)前后病理變化,采用自身對照對比陰道鏡指引下多點(diǎn)活檢診斷結(jié)果和最終病理結(jié)果。結(jié)果陰道鏡指引下多點(diǎn)活檢診斷結(jié)果與LEEP手術(shù)后病理診斷結(jié)果相符者336例(86.94%),其中29例(7.04%)診斷不足,10例(2.43%)診斷過度。陰道鏡指引下多點(diǎn)活檢診斷慢性宮頸炎與病理結(jié)果一致性比較Kappa值為0.75,扁平濕疣/疣樣病變診斷Kappa值0.65,子宮頸上皮內(nèi)瘤變(CIN)Ⅰ診斷Kappa值0.78,CINⅡ/Ⅲ診斷Kappa值0.77,原位癌診斷Kappa值0.69,微小浸潤癌診斷Kappa值0.75。本次研究樣本中最終13例診斷為宮頸浸潤癌,漏診率為23.08%,對CINⅡ/Ⅲ級的漏診率為7.65%,CINⅠ漏診率7.50%,扁平濕疣/疣樣病變漏診率36.36%,慢性宮頸炎漏診率9.95%。細(xì)胞學(xué)檢查示高度鱗狀上皮內(nèi)病變(HSIL)及以上者陰道鏡指引下多點(diǎn)活檢的漏診率23.61%,顯著高于低度鱗狀上皮內(nèi)病變(LSIL)及以下者2.15%(χ~2=8.643,P0.05)。結(jié)論陰道鏡指引下多點(diǎn)活檢是早期診斷宮頸癌的有效方法,但其有可能漏診高級別的宮頸癌及宮頸微小浸潤癌。
[Abstract]:Objective to investigate the clinical effect of multipoint biopsy under colposcopy for early cervical cancer. Methods 412 patients with abnormal detection of HPV and cervical cytology were studied. Under the guidance of colposcopy, multipoint biopsy and circular electroresection of cervix were performed. The pathological changes of the patients before and after LEEP operation were analyzed retrospectively. The results of multipoint biopsy under colposcopy and final pathological results were compared by self-control. Results the diagnosis of multipoint biopsy under colposcopy was consistent with that of LEEP operation in 336 cases (29 of them were diagnosed by 7.04). Under the guidance of colposcopy, the consistency of pathological results with multipoint biopsy in the diagnosis of chronic cervicitis was 0.75, Kappa value of flat condyloma / verrucous lesion was 0.65, Kappa value of cervical intraepithelial neoplasia 鈪，

本文編號：1584305