【摘要】：目的:探討陰道鏡下宮頸活檢診斷宮頸上皮內(nèi)瘤變(CIN)的準(zhǔn)確性及其漏診宮頸癌的相關(guān)因素分析。方法:回顧性分析陰道鏡下宮頸活檢確診的587例CIN患者臨床資料,均行宮頸LEEP術(shù),以術(shù)后病理檢查為金標(biāo)準(zhǔn),觀察陰道鏡下宮頸活檢CIN的準(zhǔn)確性,并采用單因素及Logistic回歸分析影響宮頸癌漏診的相關(guān)因素。結(jié)果:587例患者陰道鏡下活檢與LEEP術(shù)后病理檢查符合率為78.2%,病理級別上升50例(8.5%),其中漏診浸潤癌29例。術(shù)后提示病理降級的有78例(13.3%)。單因素分析顯示:年齡≥55歲、陰道鏡圖像不滿意、宮頸病變面積1/2者宮頸癌漏診率較高,差異有統(tǒng)計學(xué)意義(P0.05),而HPV和TCT檢測結(jié)果在影響宮頸癌漏診率方面差異無統(tǒng)計學(xué)意義(P0.05)。Logistic回歸分析示:年齡≥55歲、陰道鏡圖像不滿意、宮頸病變面積1/2者均與宮頸癌的漏診相關(guān)(P0.05)。結(jié)論:陰道鏡檢查對CIN的診斷存在一定的不準(zhǔn)確性,可導(dǎo)致宮頸癌的誤診,提高臨床醫(yī)師對陰道鏡的操作技能,積極多點活檢,尤其關(guān)注陰道鏡圖像不滿意患者和老年婦女是降低宮頸癌漏診率的關(guān)鍵。
[Abstract]:Objective: to investigate the accuracy of cervical biopsy under colposcopy in the diagnosis of cervical intraepithelial neoplasia (CIN) and the related factors of missed diagnosis of cervical carcinoma. Methods: the clinical data of 587 patients with CIN diagnosed by colposcopy cervical biopsy were retrospectively analyzed. The accuracy of CIN in cervical biopsy under colposcopy was observed according to the gold standard of postoperative pathological examination. Univariate and Logistic regression analysis were used to analyze the factors related to missed diagnosis of cervical cancer. Results: the coincidence rate of colposcopy biopsy and LEEP was 78.2, and the pathological grade increased in 50 cases (8.5%), 29 of them missed diagnosis of invasive carcinoma. 78 cases (13.3%) showed pathological degradation after operation. Univariate analysis showed that age 鈮，

本文編號：2269767