改良三阶梯技术在子宫颈疾病诊治的临床应用
|
摘要
目的:探讨改良三阶梯技术(TCT联合HR-HPV DNA→阴道镜→宫颈病理学)在县区级医院子宫颈病变诊治过程中的临床应用价值。方法:2016年1月至2017年2月在本院妇科就诊需行子宫颈检查或体检中心行妇科体检的非妊娠期女性患者共216例,年龄42±10.9岁,均无子宫、宫颈手术史。所有入组的患者均行HR-HPV DNA与TCT检查,对HPV检测阳性,或(和)TCT分级ASCUS及以上的阳性病变病例,再做阴道镜检查。之后根据结合阴道镜下决定行宫颈活检术,或者直接性LEEP活检。分析TCT细胞学与HR-HPV DNA结果、阴道镜、病理结果。结果:TCT结合HP-HPV DNA联合检测明显提高了宫颈病变的检出率和准确性,有利于早期发现宫颈病变。阴道镜检查指导下活检病理检查可进一步提高宫颈上皮内瘤变的检出率。结论:改良三阶梯技术方案操作简便、快捷、准确,适合在县区级医院子宫颈病变诊治中推广应用。
Objective:To investigate the improved three step technique(HR-HPV DNA combined with TCT and colposcopy or cervical pathology) technique in diagnosis and treatment of cervical diseases in county hospitals. Method:From January 2016 to February 2017, 216 cases of non pregnant female patients who underwent gynecological examination or physical examination in the Department of Gynecology of our hospital from January to December in the year of the year of the hospital in our hospital were included in this study. The patients were aged from 42 to 10.9 years old. All the patients in the group were examined by HR-HPV DNA and TCT, positive for HPV, or(and) TCT positive lesions of ASCUS and above, and then colposcopy. Cervical biopsy was performed on the basis of colposcopy, or direct LEEP biopsy. Results:Combined detection of TCT and HP-HPV can significantly improve the detection rate and accuracy of cervical lesions, which is helpful for the early detection of cCervical lesions in DNA. Pathological examination of biopsy guided by colposcopy can improve the detection rate of cervical intraepithelial neoplasia. Conclusion:Scheme of improved three step technique is simple, fast and accurate, suitable for application in county level hospital in the diagnosis and treatment of cervical lesions.
Objective:To investigate the improved three step technique(HR-HPV DNA combined with TCT and colposcopy or cervical pathology) technique in diagnosis and treatment of cervical diseases in county hospitals. Method:From January 2016 to February 2017, 216 cases of non pregnant female patients who underwent gynecological examination or physical examination in the Department of Gynecology of our hospital from January to December in the year of the year of the hospital in our hospital were included in this study. The patients were aged from 42 to 10.9 years old. All the patients in the group were examined by HR-HPV DNA and TCT, positive for HPV, or(and) TCT positive lesions of ASCUS and above, and then colposcopy. Cervical biopsy was performed on the basis of colposcopy, or direct LEEP biopsy. Results:Combined detection of TCT and HP-HPV can significantly improve the detection rate and accuracy of cervical lesions, which is helpful for the early detection of cCervical lesions in DNA. Pathological examination of biopsy guided by colposcopy can improve the detection rate of cervical intraepithelial neoplasia. Conclusion:Scheme of improved three step technique is simple, fast and accurate, suitable for application in county level hospital in the diagnosis and treatment of cervical lesions.
引文
[1]谢幸,苟文丽主编.妇产科学[M]第8版.人民卫生出版社,2013,301-309
[2]Belinson J L,Pretorius R G,Zhang W H,et al.Cervical cancer screening by simple visual inspection after acetic acid☆[J].Obstetrics&Gynecology,2001,98(3):441-444.
[3]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志电子版,2015,11(2):1-6.
[4]朱方培,任青玲.宫颈癌及癌前病变早期筛查的新进展[J].现代肿瘤医学,2016(1):149-152.
[5]潘秦镜,李凌,乔友林,等.液基细胞学筛查宫颈癌的研究[J].中华肿瘤杂志,2001,23(4):309-312.
[2]Belinson J L,Pretorius R G,Zhang W H,et al.Cervical cancer screening by simple visual inspection after acetic acid☆[J].Obstetrics&Gynecology,2001,98(3):441-444.
[3]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志电子版,2015,11(2):1-6.
[4]朱方培,任青玲.宫颈癌及癌前病变早期筛查的新进展[J].现代肿瘤医学,2016(1):149-152.
[5]潘秦镜,李凌,乔友林,等.液基细胞学筛查宫颈癌的研究[J].中华肿瘤杂志,2001,23(4):309-312.