本文選題：快速冷凍診斷　切入點：盧戈氏碘　出處：《鄭州大學》2017年碩士論文

【摘要】：目的評估快速冷凍診斷對宮頸鱗狀上皮內病變的診斷準確性與局限性。分析快速冷凍檢查時,探討盧戈氏碘試驗肉眼觀察(visual inspection with lugol’s iodine,VILI)法在冷凍診斷宮頸鱗狀上皮內病變中的價值。方法收集2016年3月至2016年7月鄭州大學第一附屬醫(yī)院行快速冷凍檢查(frozen section examination,FSE)的宮頸錐切病例共384例。最終篩選出294例病例做回顧性分析�；颊呓橛�18~90歲年齡之間,年齡平均為43.54歲。其中150例錐切標本未行VILI實驗;另144例錐切標本行VILI實驗。如常規(guī)診斷為可疑診斷,再行免疫組化協(xié)診后得出最終常規(guī)診斷。所有納入研究的患者均符合宮頸錐切術適應癥等納入標準并均已簽署知情同意書。使用SPSS17.0軟件,比較FSE診斷與最終常規(guī)石蠟檢查(paraffin section xamination,PSE)診斷的各項統(tǒng)計學數(shù)據(jù),如陽性預測值(positive predictive value,+PV)、陰性預測值(negative predictive value,-PV)、真陽性率即靈敏度(sensitivity,Se)、真陰性率即特異度(specificity,Sp)、陽性似然比(positive likelihood ratio,+LR)、陰性似然比(negative likelihood ratio,-LR)、正確指數(shù)即約登指數(shù)(Youden's index)和診斷優(yōu)勢比(diagnostic odds ratio,DOR)和符合率。并對以上指標進行數(shù)據(jù)統(tǒng)計學分析。以百分率表示計數(shù)資料,使用χ2檢驗對數(shù)據(jù)進行計數(shù)資料的統(tǒng)計學分析,以α=0.05為檢驗水準。結果VILI組:在FSE宮頸炎性病變診斷方面,其Se、Sp、+PV、-PV、+LR、-LR、DOR、Youden's index和符合率分別為94.12%、72.73%、77.53%、92.52%、3.45、0.08、2.67、0.67和77.78%,在FSE宮頸低級別上皮內病變(low-grade squamous intraepithelial lesion,LSIL)診斷方面,其Se、Sp、+PV、-PV、+LR、-LR、DOR、Youden's index和符合率分別為57.14%、89.91%、84.99%、67.72%、5.66、0.48、11.88、0.47和81.94%;在FSE宮頸高級別上皮內病變(high-grade squamous intraepithelial lesion,HSIL)診斷方面,其Se、Sp、+PV、-PV、+LR、-LR、DOR、Youden's index和符合率分別為66.67%、98.55%、97.87%、74.73%、46.00、0.34、136.00、0.65和81.94%。非VILI組:在FSE宮頸炎性病變診斷方面,其Se、Sp、+PV、-PV、+LR、-LR、DOR、Youden's index和符合率分別為96.77%、58.82%、70.15%、94.80%、2.35、0.05、42.86、0.56和66.66%;在FSE宮頸LSIL診斷方面,其Se、Sp、+PV、-PV、+LR、-LR、DOR、Youden's index和符合率分別為35.62%、89.51%、74.72%、57.79%、2.96、0.65、4.45、0.24和80.00%;在FSE宮頸HSIL診斷方面,其Se、Sp、+PV、-PV、+LR、-LR、DOR、Youden's index和符合率分別為51.62%、98.25%、96.71%、67.00%、29.42、0.49、59.73、0.49和69.33%。通過χ2檢驗,VILI組準確率(70.83%)高于非VILI組(58%),兩組實驗診斷準確性上存在差異,差異具有統(tǒng)計學意義(P0.05)。結論VILI有助于提高冷凍檢查時對宮頸上皮內病變的診斷準確率。
[Abstract]:Objective to evaluate the accuracy and limitation of rapid frozen diagnosis for cervical squamous intraepithelial lesions.To investigate the value of Lugo's iodine test in the diagnosis of cervical squamous intraepithelial lesions by using visual inspection with lugol's iodine vii.Methods from March 2016 to July 2016, 384 cases of cervical conization were collected from the first affiliated Hospital of Zhengzhou University.294 cases were selected for retrospective analysis.The patient was between 18 and 90 years old, with an average age of 43.54 years.VILI test was not performed in 150 conical specimens and VILI test was performed in 144 conical specimens.If the routine diagnosis is suspicious, the final routine diagnosis can be obtained by immunohistochemistry.All patients included in the study met the inclusion criteria for cervical conization and signed informed consent.SPSS17.0 software was used to compare the statistical data between FSE diagnosis and final routine paraffin examination (PSE).Diagnostic odds and coincidence rate.And the above indicators were statistically analyzed.The counting data were expressed by percentage, and the count data were analyzed statistically by 蠂 2 test, and the test level was 偽 0.05.鍏禨e,Sp, PV,-PV, LR,-LR,DOR,Youden's index鍜岀鍚堢巼鍒嗗埆涓，

本文編號：1715431