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目的比较阴道镜指引下多点活检与宫颈锥切术后病理结果的差异,指导CIN2+的临床处理。方法645例阴道镜指引下多点活检病理为CIN2+患者行子宫颈锥切术,对比锥切术前后的病理结果。结果子宫颈锥切术前后CIN2/3病理的一致性为72.86%,漏诊2.22%宫颈浸润癌;CIN2与CIN3患者锥切术后病理升级为鳞状细胞癌的几率差异有统计学意义(0.3%vs.4.4%,P=0.000),CIN2与CIN3患者锥切术后病理降级为低级别病变或炎症的几率差异有统计学意义(39.5%vs.11.3%,P=0.002)。结论阴道镜指引下子宫颈多点活检与子宫颈锥切术后的病理一致性为72.86%,有2.2%的非预期子宫颈浸润癌的可能。
Objective To compare the difference of pathological results between colposcopy and multipoint biopsy guided by colposcopy to guide the clinical treatment of CIN2 +. Methods 645 cases under the guidance of colposcopy biopsy pathology CIN2 + patients underwent cervical conization, conization compared the pathological results. Results The consistency of CIN2 / 3 pathology before and after cervical conization was 72.86%, missed by 2.22% of invasive cervical cancer. There was significant difference in the pathological grade of squamous cell carcinoma after conization of CIN2 and CIN3 % vs.4.4%, P = 0.000). There was a statistically significant difference in the pathological grade between CIN2 and CIN3 patients after conization (39.5% vs.11.3%, P = 0.002). Conclusions Colposcopy guided by multi-point biopsy and cervical conization after the pathological consistency was 72.86%, with 2.2% of the expected non-invasive cervical cancer possible.