摘要
目的探讨阴道镜诊断CIN的准确性及漏诊宫颈癌的相关因素。方法在2018年6月至2019年6月我院收治的行阴道镜下活检诊断CIN且在确诊后行手术治疗的患者中选取58例作为研究对象,回顾性分析其临床诊治资料,以术后病理组织学检查结果作为黄金标准,计算阴道镜下活检诊断CIN的准确率,并对漏诊宫颈癌的相关因素进行分析。结果本组患者经阴道镜下活检诊断与术后病理组织学检查结果相符的有34例,诊断准确率为58.62%;术后提示病理升级的有11例,占比18.97%,其中漏诊宫颈癌的有7例,漏诊率为12.07%;术后提示病理降级的有14例,占比24.14%;阴道镜下活检诊断与术后病理组织学检查的一致性一般(Kappa=0.43,P=0.064)。单因素分析显示:未行ECC(宫颈管搔刮)是漏诊宫颈癌的独立危险因素(P<0.05);其他各项因素与漏诊宫颈癌的相关性均不显著(P>0.05)。结论虽然阴道镜下活检诊断是一种比较直观的CIN诊断方法,但其诊断准确率不足,且存在一定的漏诊宫颈癌的风险,若想降低宫颈癌漏诊率需行ECC。
Objective To investigate accuracy of colposcopy in diagnosis of CIN and related factors of missed diagnosis of cervical cancer.Methods We chose 58 cases of colposcopy biopsy patients for CIN diagnosis in our hospital from June 2018 to June 2019 as research objects,who were treated with surgical treatment after diagnosis.Reviewed and analyzed clinical diagnosis and treatment data,with gold standard of postoperative histopathological examination results,calculated accuracy rate of CIN diagnosis by colposcopy biopsy,and analyze related factors of missed diagnosis of cervical cancer.Results 34 cases with biopsy diagnosis of colposcopy were consistent with postoperative histopathological examination results,with diagnosis accuracy rate of 58.62%;11 cases showed postoperative pathological escalation,accounting for 18.97%,of which 7 cases were missed diagnosis of cervical cancer,with missed diagnosis rate of 12.07%;14 cases showed postoperative pathological degradation,accounting for 24.14%;consistency of biopsy diagnosis under colposcopy and postoperative histopathological examination was not satisfying(Kappa=0.43,P=0.064).Univariate analysis showed absence of ECC was independent risk factor for missed cervical cancer(P<0.05);correlation between other factors and missed cervical cancer was not significant(P>0.05).Conclusion Although colposcopy biopsy diagnosis is a relatively intuitive method for CIN diagnosis,it has insufficient diagnostic accuracy with some certain risks of missed diagnosis of cervical cancer.It is necessary to examine ECC to reduce missed diagnosis rate of cervical cancer.
作者
张静
ZHANG Jing(Shandong Electric Power Central Hospital,Jinan,Shandong,250000)
出处
《智慧健康》
2020年第30期13-14,共2页
Smart Healthcare
关键词
阴道镜
CIN
宫颈癌
相关因素
Colposcopy
CIN
Cervical cancer
Related factors
