陰道鏡直視宮頸多點活檢與常規宮頸活檢對宮頸疾病診斷價值的對比研究

摘要：目的 比較直視宮頸多點活檢與常規宮頸活檢在宮頸疾病診斷中的差異。方法 采用回顧性分析法，對我院曾收治并行宮頸錐切術確診的宮頸疾病患者，共計218例，按照術前采用直視多點活檢或常規活檢分組為觀察組和對照組。分別比較兩組診斷符合率，靈敏度、特異性、陽性預測值、陰性預測值、宮頸浸潤癌漏診率等指標。結果 觀察組靈敏度為97.8%，特異性為96.8%，陽性預測值91.2%，陰性預測值96.5%，宮頸浸潤癌漏診率為8.3%；而對照組靈敏度為61.4%，特異性85.4%，陽性預測值54.3%，陰性預測值88.2%，宮頸浸潤癌漏診率75%。結論 直視宮頸多點活檢在宮頸疾病中具有較高的靈敏度及診斷符合率，尤其是對于CIN類型及浸潤癌的診斷，具有較高臨床應用價值。

關鍵詞：陰道鏡；多點活檢；常規活檢；宮頸疾病；診斷

Abstract：Objective Compare look cervical biopsy with conventional multi-point difference in cervical biopsy in the diagnosis of cervical disease. Methods A retrospective analysis of our hospital has treated patients with concurrent cervical conization diagnosed with the disease， a total of 218 cases， depending on the preoperative biopsy or the use of multi-point look routine biopsy grouped into observation group and control group. The two groups were compared for diagnostic accuracy， sensitivity， specificity， positive predictive value， negative predictive value， invasive cervical cancer misdiagnosis rate and other indicators. Results The sensitivity of the observation group was 97.8%， specificity 96.8%， positive predictive value of 91.2%， negative predictive value of 96.5%， invasive cervical cancer misdiagnosis rate was 8.3%； sensitivity of the control group was 61.4%， specificity 85.4%， positive predictive value 54.3%， negative predictive value of 88.2% of invasive cervical cancer misdiagnosis rate of 75%. Conclusion Look cervix multiple biopsies with high sensitivity and diagnostic accuracy of cervical disease， especially for the type of CIN and invasive diagnosis. Their results are satisfactory， with a high clinical value.

Key words：Colposcopy； Multipoint biopsy； Routine biopsy；Cervical disease；Diagnosis

目前，隨著生活方式改變及生活節奏的加快，女性在工作、生活中的角色也日益重要，但隨之而來的健康問題也格外突出。其中，以宮頸病變所致的宮頸癌最為突出及嚴重[1]。據相關研究報道，我國每年新增宮頸癌患者約占全世界新增患者的1/3[2]，且近幾年隨著發病率的上升，呈現出年輕化趨勢[3]。臨床研究顯示，宮頸組織由癌前病變進展為宮頸癌往往需要較長時間，因此，若能采取早發現、早干預、早治療的策略，將有效減低患者的發病率及死亡率，提高治療的有效率[4]。

1 資料與方法

1.1一般資料 回顧性分析我院于2010年1月～2013年12月收治的218例行宮頸錐切術的宮頸疾病患者，患者年齡為21～65歲，平均年齡（33.2±3.6）歲，產次0～5次，平均（1.51±0.62）次。……