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目的:探讨阴道镜下活检对诊断宫颈病变的价值。方法:对2001年1月至2004年12月2116例阴道镜下对异常图像者定位活检以病理结果作对照进行宫颈病灶准确性的对照分析。结果:2116例阴道镜下定位活检经病理确诊宫颈上皮内瘤变(CIN)308例,其中包括CINⅠ226例,CINⅡ65例,CINⅢ17例;宫颈原位癌13例,浸润癌53例,慢性宫颈炎(包括宫颈息肉)1669例,子宫内膜异位症8例,宫颈湿疣65例。1例病人可有1种或多种阴道镜下异常图像。浸润癌阴道镜下图像主要是血管异常;原位癌(CIS)阴道镜下图像均见醋酸白色上皮,多数伴有点状血管、异型血管、镶嵌或白斑等;CIN以醋酸白色上皮出现率最高,异型血管、点状血管、镶嵌、白环白腺次之;慢性宫颈炎以不典型点状血管及醋酸白色上皮检出率居多。结论:阴道镜检查对宫颈癌,尤其是癌前病变的早期诊断有重要价值,阴道镜下定位活检可提高宫颈病变诊断的准确性和检出率。
Objective: To investigate the value of colposcopy biopsy in the diagnosis of cervical lesions. Methods: From January 2001 to December 2004, 2116 colposcopes were retrospectively analyzed for the accuracy of cervical lesions by pathological biopsy. Results: Of the 2116 cases with cervical intraepithelial neoplasia (CIN), 308 were diagnosed by colposcopy biopsy, including CINⅠ226 cases, CINⅡ65 cases and CINⅢ17 cases; cervical carcinoma in situ in 13 cases, invasive carcinoma in 53 cases, chronic cervicitis Including cervical polyps) 1669 cases, 8 cases of endometriosis, cervical condyloma 65 cases. One patient may have one or more abnormal colposcopy images. Colposcopy of invasive carcinoma is mainly vascular abnormalities; colposcopic carcinoma (CIS) colposcopy images are seen in white epithelium acetate, most associated with punctate vessels, abnormal blood vessels, mosaic or leukoplakia; CIN to acetic acid white epithelium highest rate, Shaped vessels, punctate vessels, inlaid, white ring next to the white ring; chronic cervicitis with atypical punctate vessels and acetic acid white epithelium most of the detection rate. Conclusion: Colposcopy has important value in the early diagnosis of cervical cancer, especially precancerous lesions. Colposcopic biopsy can improve the diagnostic accuracy and detection rate of cervical lesions.