TCT、HPV检测、阴道镜活检及LEEP在宫颈癌及癌前病变中的临床价值

发布时间：2018-04-26 19:39

  本文选题：液基薄层细胞学 + 阴道镜活检HPV检测　； 参考：《中国继续医学教育》2016年33期

【摘要】：目的探讨TCT检查、HPV检测、阴道镜宫颈活检、LEEP术在子宫颈上皮内瘤病变中临床意义。方法 2011年9月~2015年1月在连云港市第一人民医院就诊的患者共2 146例,术前常规行TCT检查,338例患者在阴道镜下宫颈活检之后,提示宫颈上皮内高度病变,行环形电切术治疗,标本行病理学检查。结果 (1)2 146例患者TCT检查,308例异常占14.35%;其中97例ASCUS占31.49%;153例LSIL占49.68%;49例HSIL占15.91%;9例SCC占2.92%。(2)TCT与LEEP术后病理比较,TCT阳性报告者中CIN及宫颈癌检出率为83.12%。LSIL诊断符合率62.75%,HSIL诊断符合率85.71%,LSIL与HSIL诊断符合率的差异有统计学意义(χ2=5.82,P0.05)。(3)HPV检测及联合TCT检测结果:CIN检出率93.53%,其中CINⅡ~Ⅲ检出率为50.86%。(4)338例LEEP术后病理与阴道镜活检病理诊断符合率为66.56%。结论 TCT是宫颈疾病筛查的主要方法,HPV阳性筛查率与病理级别呈正相关,TCT与HPV联合检测能提高宫颈病变检出率,对宫颈癌早期发现有指导意义;宫颈活检不易检查出子宫颈深部组织及颈管内病变,LEEP术既能有效诊断子宫颈病变,同时有治疗作用。
[Abstract]:Objective to investigate the clinical significance of TCT in cervical intraepithelial neoplasia. Methods from September 2011 to January 2015, a total of 2 146 patients were admitted to Lianyungang first people's Hospital. Preoperative TCT examination was performed in 338 patients with cervical biopsy under colposcopy. The specimens were examined by pathology. Results among the 2 146 patients with TCT, 308 cases were abnormal in TCT examination and 97 cases with ASCUS accounted for 31.49 cases. 153 cases with LSIL and 49 cases with HSIL accounted for 15.91%. The positive rate of CIN and cervical cancer was 62.75 HSIL diagnostic coincidence rate between 2.92%.(2)TCT and LEEP. The diagnostic coincidence rate between LSIL and HSIL was statistically significant (蠂 ~ (2) ~ (5.82) (蠂 ~ (2 +) 5.82) and combined TCT examination. The detection rate of CIN 鈪，

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