阴道镜下宫颈活检的准确性及宫颈癌漏诊相关因素分析

发布时间：2018-10-13 20:13

【摘要】：目的:探讨阴道镜下宫颈活检诊断宫颈上皮内瘤变(CIN)的准确性及其漏诊宫颈癌的相关因素分析。方法:回顾性分析阴道镜下宫颈活检确诊的587例CIN患者临床资料,均行宫颈LEEP术,以术后病理检查为金标准,观察阴道镜下宫颈活检CIN的准确性,并采用单因素及Logistic回归分析影响宫颈癌漏诊的相关因素。结果:587例患者阴道镜下活检与LEEP术后病理检查符合率为78.2%,病理级别上升50例(8.5%),其中漏诊浸润癌29例。术后提示病理降级的有78例(13.3%)。单因素分析显示:年龄≥55岁、阴道镜图像不满意、宫颈病变面积1/2者宫颈癌漏诊率较高,差异有统计学意义(P0.05),而HPV和TCT检测结果在影响宫颈癌漏诊率方面差异无统计学意义(P0.05)。Logistic回归分析示:年龄≥55岁、阴道镜图像不满意、宫颈病变面积1/2者均与宫颈癌的漏诊相关(P0.05)。结论:阴道镜检查对CIN的诊断存在一定的不准确性,可导致宫颈癌的误诊,提高临床医师对阴道镜的操作技能,积极多点活检,尤其关注阴道镜图像不满意患者和老年妇女是降低宫颈癌漏诊率的关键。
[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，

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