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目的:观察“三阶梯”诊疗程序筛查宫颈癌前病变的效果。方法:对妇保门诊的687例患者行宫颈细胞学检测,对筛查出的42例异常细胞学患者行阴道镜检查及其定位下的宫颈多点活检的组织学检查。结果:液基细胞学(TCT)筛查687例,机会性筛查率为69.0%(687/996);TCT筛查出ASCUS以上异常病例42例,检出率为6.1%,其中ASCUS 34例,占81.0%,高级别细胞学异常8例,占19.0%,包括6例HPV感染,构成比为75.0%(6/8);42例异常细胞学患者经阴道镜检查出C INⅡ及C INⅢ11例,检出率为26.2%;经宫颈活检的组织病理学检出C INⅡ、C INⅢ10例,检出率为23.8%。经组织学评价阴道镜检出高级别C INⅡ、C INⅢ的灵敏度为90.9%,特异度为72.4%。结论:宫颈细胞学、阴道镜与组织病理学三阶梯技术筛查宫颈癌前病变有很好的相关性,可有效的筛查宫颈癌前病变。
Objective: To observe the effect of screening the precancerous lesions of cervical cancer by the “three-step” diagnosis and treatment program. Methods: Cervical cytology was performed on 687 women undergoing maternity protection clinics. Collected 42 cases of abnormal cytology patients underwent colposcopy and histological examinations of multiple cervical biopsy under their position. RESULTS: Sixty-eight (687) cases were screened by liquid-based cytology (TCT), with an opportunistic screening rate of 69.0% (687/996). Forty-two cases of abnormal ASCUS were detected by TCT, with a detection rate of 6.1% , Accounting for 81.0%. There were 8 cases of high grade cytology abnormalities (19.0%), including 6 cases of HPV infection, with a comparision of 75.0% (6/8). CINⅡ and CINⅢ11 were detected by colposcopy in 42 cases of abnormal cytology Cases, the detection rate was 26.2%; by histopathology of cervical biopsy C IN Ⅱ, C IN Ⅲ 10 cases, the detection rate was 23.8%. Histological evaluation colposcopy detected high-grade C IN Ⅱ, C IN Ⅲ sensitivity was 90.9%, specificity was 72.4%. Conclusion: Cervical cytology, colposcopy and histopathology three-step ladder screening of precancerous lesions have a good correlation, can effectively screen for cervical precancerous lesions.