阴道镜检查宫颈上皮内瘤变的有效性及其与组织病理学检查报告的相关性

Vijayasree Medarametla
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摘要

目的:本研究的目的是通过细胞学筛查宫颈不健康的妇女,并将结果与阴道镜检查和阴道镜指导下的活检相关联。材料与方法:本前瞻性研究于2011年10月至2013年6月在阿曼玛玛塔医学院妇产科进行。总共有100例符合选择标准的病例被纳入研究。所有参与研究的女性都接受了子宫颈抹片检查、阴道镜检查和阴道镜指导下的活检。计算子宫颈抹片检查和阴道镜检查的敏感性、特异性、阳性预测值、阴性预测值、假阳性率、假阴性率和准确性,以阴道镜引导活检为金标准。结果:巴氏涂片的敏感性和特异性分别为54.3%和96.2%,阴道镜检查的敏感性和特异性分别为76.1%和96.2%。阴道镜检查的灵敏度高于巴氏涂片检查。巴氏涂片和阴道镜检查的特异性和阳性预测值具有可比性,而阴道镜检查的准确性高于巴氏涂片检查。结论:患者以31 ~ 40岁年龄组居多。最常见的症状是反复出现阴道白色分泌物。阴道镜检查宫颈上皮内瘤变是有用的。阴道镜检查和细胞学检查在宫颈病变患者中发现鳞状上皮内病变/恶性肿瘤的机会高于单独使用任何一种检查。
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Effectiveness of Colposcopy in the Detection of Cervical Intraepithelial Neoplasias and its Correlation with a Histopathological Examination Report
Objectives: The objectives of the study were to screen women who have an unhealthy cervix by cytology and correlate the findings with colposcopy, and colposcopic-directed biopsies. Materials and methods: This is a prospective study conducted in the Department of Obstetrics and Gynecology in Mamata Medical College, Khammam, from October 2011 to June 2013. A total of 100 cases who fulfilled the selection criteria were included in the study. All the women enrolled in the study underwent a pap smear, colposcopy, and a colposcopic-directed biopsy. The sensitivity, specificity, positive predictive value, negative predictive value, false-positive rate, false-negative rate, and accuracy were calculated for the Pap smear and colposcopy, with the colpscopic-directed biopsy taken as the gold standard. Results: The sensitivity and specificity of the Pap smear were found to be 54.3% and 96.2%, respectively, and those of the colposcopy were 76.1% and 96.2%, respectively. The colposcopy showed a higher sensitivity than did the Pap smear. The specificity and positive predictive value of the Pap smear and colposcopy was comparable, whereas the accuracy of the colposcopy was higher than that of the Pap smear. Conclusion: Most of the women were in the age group of 31–40 years. The most common symptom was a recurrent white discharge per vagina. Colposcopy was useful in detecting cervical intraepithelial neoplasias. Colposcopy and cytology used together in patients with cervical lesions have a higher chance of detecting squamous intraepithelial lesions/malignancy than when either procedure used alone.
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