阴道镜下宫颈活检对宫颈癌的诊断价值及漏诊因素分析
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摘要
目的分析阴道镜下宫颈活检对宫颈癌诊断价值及漏诊因素。方法选取2016年5月至2018年5月我院收治的60例手术切除组织行病理检查证实为宫颈癌患者,术前均在阴道镜下取宫颈组织行病理诊断,分析阴道镜下宫颈活检对宫颈癌的诊断价值及漏诊因素。结果 60例患者经阴道镜下宫颈活检,宫颈癌诊断率为61.67%(37/60),漏诊率为38.33%(23/60)。单因素分析结果显示,诊断组和漏诊组的阴道流液、盆腔炎、宫颈癌分型、宫颈癌分期比较差异有统计学意义(P <0.05)。多因素分析结果显示,盆腔炎、宫颈癌分型、宫颈癌分期为影响阴道镜下宫颈活检诊断宫颈癌漏诊的独立危险因素(P <0.05)。结论阴道镜下宫颈活检诊断宫颈癌具有重要临床价值,但合并盆腔炎、宫颈癌分型和宫颈癌分期会影响其诊断准确性。
Objective To analyze the diagnostic value and missed diagnostic factors of colposcopic cervical biopsy in cervical cancer.Methods 60 cases of patients confirmed as cervical cancer by pathological examination of surgical cervical tissues in our hospital from May2016 to May 2018 were selected. The cervical tissues were given pathologic diagnosis under colposcopy before surgery. The diagnostic value and missed diagnostic factors of colposcopic cervical biopsy in cervical cancer were analyzed. Results Among 60 cases of patients with colposcopic cervical biopsy, the diagnosis rate of cervical cancer was 61.67%(37/60), and the missed diagnosis rate was 38.33%(23/60). Univariate analysis results showed that statistical difference was found in the vaginal fluid, pelvic inflammatory disease, cervical cancer classification, and cervical cancer staging between the diagnosis group and missed diagnosis group(P <0.05). Multivariate analysis results showed that the pelvic inflammatory disease, cervical cancer classification, and cervical cancer staging were independent risk factors for the missed diagnosis of cervical cancer diagnosed by colposcopic cervical biopsy(P <0.05). Conclusions Colposcopic cervical biopsy has important clinical value in the diagnosis of cervical cancer, but complicated pelvic inflammatory disease, cervical cancer classification and cervical cancer staging can affect diagnostic accuracy.
Objective To analyze the diagnostic value and missed diagnostic factors of colposcopic cervical biopsy in cervical cancer.Methods 60 cases of patients confirmed as cervical cancer by pathological examination of surgical cervical tissues in our hospital from May2016 to May 2018 were selected. The cervical tissues were given pathologic diagnosis under colposcopy before surgery. The diagnostic value and missed diagnostic factors of colposcopic cervical biopsy in cervical cancer were analyzed. Results Among 60 cases of patients with colposcopic cervical biopsy, the diagnosis rate of cervical cancer was 61.67%(37/60), and the missed diagnosis rate was 38.33%(23/60). Univariate analysis results showed that statistical difference was found in the vaginal fluid, pelvic inflammatory disease, cervical cancer classification, and cervical cancer staging between the diagnosis group and missed diagnosis group(P <0.05). Multivariate analysis results showed that the pelvic inflammatory disease, cervical cancer classification, and cervical cancer staging were independent risk factors for the missed diagnosis of cervical cancer diagnosed by colposcopic cervical biopsy(P <0.05). Conclusions Colposcopic cervical biopsy has important clinical value in the diagnosis of cervical cancer, but complicated pelvic inflammatory disease, cervical cancer classification and cervical cancer staging can affect diagnostic accuracy.
引文
[1]高静,张滢,沈琳.阴道镜下四象限活检在宫颈癌筛查诊断中的应用价值[J].中国计划生育学杂志, 2017, 25(10):697-700.
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[3]郜水菊,陈小利,徐胜东,等.阴道镜指引下多点活检检测老年早期子宫颈癌的临床效果[J].中国老年学杂志, 2017, 37(12):2960-2962.
[4]于淑莉,刘丽莉,于淑革,等. TCT阴道镜及阴道镜活组织检查联合应用在宫颈癌诊断中的价值[J].河北医学, 2016, 22(6):995-997.
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[6]季雯婷,楼微华,洪祖蓓,等.阴道镜下宫颈活检的准确性及宫颈癌漏诊相关因素分析[J].实用妇产科杂志, 2017, 33(4):277-280.
[7]陶霞.阴道镜初学者拟诊与病理诊断宫颈病变偏离原因探讨[J].实用妇产科杂志, 2017, 33(3):198-202.
[8]黄艳,陈双郧,刘庭英.阴道镜在早期宫颈癌中图像特征及临床诊断价值[J].实用癌症杂志, 2018, 33(5):773-775, 783.
[9]程静,张琼.阴道镜下活检、 TCT及HPV检测对宫颈病变的诊断价值[J].中国妇幼健康研究, 2017, 28(3):349-351.
[10]郝奕,马建红,丁洁.经阴道彩色多普勒超声联合阴道镜诊断早期宫颈癌的效果分析[J].实用癌症杂志, 2017, 32(10):1733-1734.
[2]洪威阳,胡敏. HPV、 TCT、阴道镜诊断宫颈上皮瘤变及宫颈癌的价值[J].中国妇幼健康研究, 2015, 26(6):1272-1274.
[3]郜水菊,陈小利,徐胜东,等.阴道镜指引下多点活检检测老年早期子宫颈癌的临床效果[J].中国老年学杂志, 2017, 37(12):2960-2962.
[4]于淑莉,刘丽莉,于淑革,等. TCT阴道镜及阴道镜活组织检查联合应用在宫颈癌诊断中的价值[J].河北医学, 2016, 22(6):995-997.
[5]魏娜,孙江川,常淑芳.网络质控阴道镜在宫颈癌机会筛查中的临床价值[J].实用妇产科杂志, 2015, 31(6):466-469.
[6]季雯婷,楼微华,洪祖蓓,等.阴道镜下宫颈活检的准确性及宫颈癌漏诊相关因素分析[J].实用妇产科杂志, 2017, 33(4):277-280.
[7]陶霞.阴道镜初学者拟诊与病理诊断宫颈病变偏离原因探讨[J].实用妇产科杂志, 2017, 33(3):198-202.
[8]黄艳,陈双郧,刘庭英.阴道镜在早期宫颈癌中图像特征及临床诊断价值[J].实用癌症杂志, 2018, 33(5):773-775, 783.
[9]程静,张琼.阴道镜下活检、 TCT及HPV检测对宫颈病变的诊断价值[J].中国妇幼健康研究, 2017, 28(3):349-351.
[10]郝奕,马建红,丁洁.经阴道彩色多普勒超声联合阴道镜诊断早期宫颈癌的效果分析[J].实用癌症杂志, 2017, 32(10):1733-1734.