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目的:总结宫颈刮片、阴道镜及HPV检测在宫颈病变诊断中的临床经验,对宫颈癌筛查提出合理化建议。方法:对3种方法任何一项检测异常者行阴道镜下病理活检及宫颈管搔刮,以组织学诊断作为金标准。对212例病理结果阳性(CINI、CINII、CINIII、宫颈浸润癌)的患者,比较3种方法的检出敏感度,及在细胞学及阴道镜检查中漏诊的临床体会。结果:212例病理结果阳性者中,宫颈刮片阳性者151例,敏感度为71.23%,阴道镜阳性者167例,敏感度为78.77%,两者阳性检出率相比无显著性差异(P>0.05)。高危型HPV感染者182例,敏感度83.02%,与阴道镜的敏感度相比,无显著性差异(P>0.05),与宫颈刮片相比,有显著性差异(P<0.05)。结论:宫颈癌的筛查及早期诊断,应以宫颈细胞学检查、阴道镜检查及HPV检测相互结合以提高检出率。
OBJECTIVE: To summarize the clinical experience of cervical smears, colposcopy and HPV testing in the diagnosis of cervical lesions and put forward reasonable suggestions for cervical cancer screening. Methods: All three methods of detection of abnormal colposcopic pathological biopsy and cervical scraping, with histological diagnosis as the gold standard. 212 patients with positive pathological results (CINI, CINII, CINIII, invasive cervical cancer), the detection sensitivity of the three methods, and cytology and colposcopy missed the clinical experience. Results: Of the 212 pathologically positive cases, 151 cases were positive for cervical smear, with a sensitivity of 71.23% and 167 cases of colposcopy positive with a sensitivity of 78.77%. There was no significant difference in the positive detection rate between the two P> 0.05). There were 182 cases of high risk HPV infection, the sensitivity was 83.02%, which was not significantly different from that of colposcopy (P> 0.05). Conclusion: Screening and early diagnosis of cervical cancer should be cervical cytology, colposcopy and HPV detection combined with each other to improve the detection rate.