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  • Title: [Clinical analysis of 128 cases of cervical lesion diagnosed by multi-point biopsy of colposcopy and endocervical curettage].
    Author: Liu BB, Zhu YL, Zhang WH, Zhang H, Wang XX, Yu XJ, Zhang P, Zhang J, Wang L, Fang SW, Li D, Zhen SW, Lu MH.
    Journal: Zhonghua Zhong Liu Za Zhi; 2018 Jul 23; 40(7):539-542. PubMed ID: 30060364.
    Abstract:
    Objective: To investigate the clinical values of colposcopy and cervical biopsy and/or endocervical curettage (ECC) in the diagnosis of cervical lesion. Methods: Clinical data of 128 cases of cervical lesion diagnosed by Xuzhou Cancer Hospital from January 23, 2014 to October 11, 2016 were collected and retrospectively analyzed, all patients underwent colposcopy and cervical biopsy and/or ECC. Results: Among them, the age between 30 to 50 years old were 70 cases, whose transformation zone types of Ⅰ, Ⅱ and Ⅲ were 28 cases (40.0%), 23 cases (32.9%) and 19 cases (27.1%), respectively. The age older than 50 years were 45 cases, whose transformation zone types of Ⅱ and Ⅲ were 1 case (2.2%) and 44 cases (97.8%), respectively. Among the 128 cases of cervical lesions, diagnostic results of colposcopy showed that the chronic inflammation were 57 cases, cervical intraepithelial neoplasia (CIN)Ⅰwere 35 cases, CINⅡor CINⅡ~Ⅲ were 8 cases, CIN Ⅲ were 5 cases and cervical cancer were 23 cases. Alternatively, the pathological results showed that the chronic inflammation were 81 cases, CINⅠwere 17 cases, CINⅡor CINⅡ~Ⅲ were 7 cases, CIN Ⅲ were 5 cases and cervical cancer were 18 cases, respectively. Among the 81 cases of chronic inflammation diagnosed by pathology, 52 cases (64.2%) were consistent with the diagnostic results of colposcopy. Among the 17 cases of low grade squamous epithelial cell lesion (LSIL) diagnosed by pathology, 10 cases were in agree with the diagnostic results of colposcopy. Among the 12 cases of high-grade squamous epithelial cell lesion (HSIL) diagnosed by pathology, 9 cases were concordant with the diagnostic results of colposcopy. Among the 18 cases of cervical cancer diagnosed by pathology, 17 cases were consistent with the diagnostic results of colposcopy. Conclusions: The type of transformation zone is positively correlated with the age, and it can help to choose biopsy and therapeutic manner. The diagnostic accuracies of HSIL and early stage of cervical cancer by multi-point biopsy of colposcopy and/or ECC are high. The cervical lesions which are difficultly found by direct visualization can be identified by colposcopy, and thus provides objective evidence to determine the therapeutic manner for patients with stage ⅡA of cervical cancer. 目的： 探讨阴道镜检查、宫颈多点活检和宫颈管诊刮术(ECC)在宫颈病变诊断中的临床价值。 方法： 回顾性分析2014年1月23日至2016年10月11日就诊于徐州市肿瘤医院128例患者的临床资料，所有患者均行阴道镜检查及宫颈活检和(或)ECC。 结果： 128例患者中，30~50岁患者70例，其中转化区类型为Ⅰ型28例(40.0%)，Ⅱ型23例(32.9%)，Ⅲ型19例(27.1%); >50岁患者45例，其中转化区类型为Ⅱ型1例(2.2%)，Ⅲ型44例(97.8%)。128例患者中，阴道镜诊断慢性炎症57例，宫颈上皮内瘤样病变(CIN)Ⅰ级35例，CINⅡ级+CINⅡ~Ⅲ级8例，CINⅢ级5例，可疑浸润癌23例。病理诊断慢性炎症81例，CINⅠ级17例，CINⅡ级+CINⅡ~Ⅲ级7例，CINⅢ级5例，宫颈癌18例。慢性炎症或化生患者81例，与阴道镜检查符合52例(64.2%)；低级别鳞状上皮细胞病变17例，与阴道镜检查符合10例；高级别鳞状上皮细胞病变(HSIL)12例，与阴道镜检查符合9例；宫颈癌18例，与阴道镜检查符合17例。 结论： 宫颈转化区类型与年龄呈正相关，转化区类型有助于活检和治疗方式的选择。阴道镜下宫颈多点活检和(或)ECC对HSIL和早期宫颈癌有较高的诊断准确率。阴道镜检查可发现肉眼难以鉴别的阴道受侵情况，为宫颈癌ⅡA期患者制订个体化的治疗方案提供客观依据。.
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