本文選題：宮頸腺上皮內(nèi)瘤變 + 宮頸細(xì)胞學(xué)��； 參考：《首都醫(yī)科大學(xué)》2017年碩士論文

【摘要】：【目的】探討宮頸腺上皮內(nèi)瘤變(cervical glandular intraepithelial neoplasia,CGIN)的臨床病例特點�！痉椒ā�2002年1月至2015年12月在首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院住院治療、并且病例資料完整的170例CGIN患者進(jìn)行臨床病例資料回顧性分析�！窘Y(jié)果】(1)170例CGIN患者中,單純CGIN患者37例(21.76%,37/170),合并鱗狀上皮病變者133例(78.24%,133/170);低級別CGIN患者75例(44.12%,75/170),高級別CGIN患者95例(55.88%,95/170)。(2)170例CGIN患者中,宮頸細(xì)胞學(xué)檢查有143例(84.12%,143/170)提示鱗狀上皮細(xì)胞異常,僅24例(14.12%,24/170)提示腺細(xì)胞異常;單純CGIN患者37例的宮頸細(xì)胞學(xué)檢查提示腺細(xì)胞異常者17例(45.95%,17/37),而CGIN合并CIN患者的腺細(xì)胞異常者僅7例(5.62%,7/133),兩者相比差異有統(tǒng)計學(xué)意義(p0.05);95例高級別CGIN患者中,有21例(22.11%,21/95)提示宮頸腺細(xì)胞異常,75例低級別CGIN患者中僅有3例(4.00%,3/75)提示宮頸腺細(xì)胞異常,高級別CGIN者發(fā)現(xiàn)宮頸細(xì)胞學(xué)異常明顯高于低級別CGIN,兩者相比差異顯著(p0.05)。(3)170例患者中,通過陰道鏡下宮頸活檢診斷CGIN者60例(35.29%,60/170),因CIN行宮頸錐切術(shù)后發(fā)現(xiàn)CGIN者39例(22.94%,39/170),因CIN或其他子宮良性病變行子宮切除術(shù)后發(fā)現(xiàn)CGIN者71例(41.76%,71/170);37例單純CGIN患者均通過宮頸活檢診斷(100.0%,37/37),而133例CGIN合并CIN的患者中僅有23例(17.29%,23/133)通過宮頸活檢診斷,兩者相比,差異有統(tǒng)計學(xué)意義(p0.05);在95例高級別CGIN中,有54例(56.84%,54/95)是通過宮頸活檢診斷,而75例低級別CGIN患者中,僅6例通過宮頸活檢診斷,兩者相比,差異有統(tǒng)計學(xué)意義(p0.05)。89例行宮頸錐切術(shù)的患者中,術(shù)前經(jīng)宮頸活檢診斷CGIN者17例(19.10%,17/89),其余72例(80.90%,72/89)為宮頸錐切術(shù)后診斷�！窘Y(jié)論】1、CGIN常與CIN并存;2、宮頸細(xì)胞學(xué)篩查及陰道鏡下宮頸活檢對CGIN的檢出率均較低;3、單純CGIN的術(shù)前診斷率高于CGIN合并CIN;高級別CGIN的術(shù)前診斷率高于低級別CGIN;4、CGIN陰道鏡下宮頸活檢病理結(jié)果與宮頸錐切術(shù)或子宮切除術(shù)后病理結(jié)果的符合率較低;宮頸錐切術(shù)是診斷CGIN的主要方式。
[Abstract]:[objective] to investigate the clinical features of cervical intraepithelial neoplasia (cervical glandular intraepithelial neoplasia CGIN). [methods] from January 2002 to December 2015, we hospitalized in Beijing Maternity Hospital affiliated to Capital Medical University. The clinical data of 170 patients with CGIN were analyzed retrospectively. [results] (1) among 170 patients with CGIN, There were 37 cases (21.76c / 170) of CGINs, 133 cases of squamous epithelium lesions (78.24%), 75 cases of low-grade CGINs (44.12% 75 / 170), 95 cases of high-grade CGINs (55.88% -170%). (2), 143 cases (84.12%) of them showed squamous epithelial cell abnormalities. Only 24 cases (14.12 / 170) showed abnormal glandular cells. The cervical cytological examination of 37 patients with CGIN showed that 17 cases (45.95 / 37) had abnormal glandular cells, while only 7 cases (5.62% 7 / 133) had abnormal glandular cells in CGIN with cin. The difference between them was statistically significant (p0.05) in 95 cases of high grade CGIN. There were 21 cases (22.1111 / 95) indicating abnormal cervical adenocytes and only 3 (4.00% / 75) of 75 cases of low grade CGINs showed abnormal cervical glandular cells. High grade CGINs were significantly higher than low grade CGINs, and the difference was significant (p0.05). (3) in 170 cases. 60 cases of CGIN were diagnosed by cervical biopsy under colposcopy (35.29g / 170), 39 cases (22.9439 / 170) of CGIN were found after cin cervicotomy, 71 cases (41.7671 / 170) of CGIN were found after hysterectomy for cin or other benign uterine diseases. All 37 cases of simple CGIN passed through the cervix. And out of 133 cases of CGIN with cin, only 23 (17.29 / 133) were diagnosed by cervical biopsy. The difference was statistically significant (p0.05). In 95 cases of high grade CGIN, 54 cases (56.84% 54 / 95) were diagnosed by cervical biopsy, while in 75 cases of low grade CGIN, only 6 cases were diagnosed by cervical biopsy. The difference was statistically significant (p0.05) .89 patients undergoing cervical conization, 17 cases (19.10% 17 / 89) were diagnosed by cervical biopsy before operation, the other 72 cases (80.90) were diagnosed after cervix conization. [conclusion] 1CGIN often coexisted with cin. The detection rate of CGIN in cervical cytology and cervical biopsy under colposcopy was lower than 3 cases. The preoperative diagnosis rate of high grade CGIN was higher than that of low grade CGIN4 CGIN with cin, and the coincidence rate between the pathological results of cervical biopsy under CGIN4 and cervical conization or hysterectomy was lower than that of high grade CGIN. Cervical conization is the main way to diagnose CGIN.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.33

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