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目的:评价光电阴道镜及宫颈管刮片对子宫颈癌前病变的筛查价值。方法:对900例门诊宫颈病变患者进行前瞻性研究,阴道镜检查并在阴道镜下行定点活检的同时进行宫颈管诊刮涂片。两种检查方法与病理学检查相对照。结果:900例患者中病理结果回报子宫颈癌前病变60例,发生率为6.7%,其中子宫颈上皮内瘤变42例,宫颈原位癌18例。阴道镜对CIN或CIS的诊断符合率66.7%,宫颈管刮片对CIN或CIS的阳性符合率16.7%。阴道镜检查和/或子宫颈管刮片两者结合阳性率75%,两者结合阳性率提高不明显,阴道镜检查与阴道镜联合子宫颈管刮片之间无差异性,P>0.05。结论:光电阴道镜在宫颈上皮内瘤变及宫颈癌早期诊断中具有重要作用,阴道镜下活组织病理检查阳性率高,宫颈管刮片在子宫颈癌前病变早期诊断中阳性率低,没有必要对子宫颈病变常规行宫颈管诊刮术,但对阴道镜检查不满意及临床可疑病例仍然具有重要作用。
Objective: To evaluate the screening value of photopic colposcopy and cervical canal curettage in cervical precancerous lesions. Methods: 900 cases of outpatient cervical lesions in patients with prospective study, colposcopy and biopsy colposcopy line at the same time for cervical smear smear. The two methods of examination were compared with pathological examination. Results: The pathological results of 900 patients were reported in 60 cases of cervical precancerous lesions, the incidence was 6.7%, including 42 cases of cervical intraepithelial neoplasia and 18 cases of cervical carcinoma in situ. Colposcopy on the diagnosis of CIN or CIS coincidence rate of 66.7%, cervical tube scraping positive for CIN or CIS 16.7%. Colposcopy and / or cervical canal smear combined positive rate of 75%, the combination of the two positive rate was not obvious, colposcopy and colposcopy combined with cervical tube scraper no difference between P> 0.05. Conclusion: Colposcopy has an important role in the early diagnosis of cervical intraepithelial neoplasia and cervical cancer. The positive rate of colposcopy biopsy is high. The positive rate of cervical smear is low in the early diagnosis of cervical precancerous lesions. Necessary cervical canal cure cervical canal curettage, but not satisfied with the colposcopy and clinical suspicion cases still have an important role.