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1、阴道镜下宫颈活检和宫颈环形电切术后病理检查对诊断宫颈病变的应用价值【摘要】目的：分析在阴道镜下进行活检及在宫颈环形电切手术后进行病理检查对于宫颈病变的诊断意义。方法：选取在我院经人乳头状瘤病毒检测及宫颈细胞学检查发现异常，或在检查无发现异常但经肉眼发现宫颈柱状上皮出现中重度外翻的患者548例，对这些患者进行阴道镜下宫颈活检及宫颈环形电切术，对比宫颈环形电切术前后的病理诊断结果的改变。结果：阴道镜下宫颈活检诊断结果与LEEP术后病理检查结果的符合率为49.27%；两种诊断方法对CIN分期II/III级及原位癌
2、诊断的一致性经Kappa分析，Kappa二0.63,—致性较高；阴道镜下宫颈活检与LEEP术后病理检查总的准确诊断率分别为82.30%、68.43%,对诊断CTNII/III级的准确诊断率分别为79.63%.81.48%,漏诊断率分别为20.37%、18.52%；阴道镜下宫颈活检与LEEP术后病理检查对CINlI/m级及原位癌的诊断与联合诊断的一致性分析，K值分别是0.80、0.83。结论：阴道镜下宫颈活检及宫颈环形电切术后的病理检查对诊断宫颈病变的诊断结果具有较高的一致性，两种方法联合诊断能显著的提高诊断
3、的准确性。【关键词】阴道镜；宫颈活检；宫颈环形电切术；宫颈病变ApplicationvalueofcolposcopecervicalbiopsyandpathologicalcxaminationinthediagnosisofcervicallesionsafterloopelectrosurgicalexcisionprocedureHUANGDingkunl,SONGLinyongl,CHENTaol,CHENJinrongl,TANGYan2.1.DepartmentofPathology,Duj
4、iangyanPeople'sHospital,Dujiangyan611830,Sichuan,China；2.DepartmentofGynecology,DujiangyanPeople'sHospital,Dujiangyan611830,Sichuan,China【Abstract】Objectives:Toanalyzeapplicationvalueofcolposcopecervicalbiopsyandpathologicalexaminationinthediagnosisofcervi
5、callesionsafterloopelectrosurgicalexcisionprocedure・Methods：548patientswhoreceivedhumanpapillomavirusdetectioninourhospitalwithabnonnalcervicalcytology,orwhohadmoderate-to-severecervicalcolumnarepitheliumwereselected.Colposcopecervicalbiopsyandloopelectros
6、urgicalexcisionprocedurewereperformed.Pathologicaldiagnosisresultsbeforeandaftertheprocedurewascompared・Results：CoincidencerateofcolposcopiccervicalbiopsyandpathologicalexaminationresultsafterLEEPwas49.27%；kappaanalysiswasconductedontheconsistencyoftwodiag
7、nosticmethodsonCINstageII/IIIandcarcinomaandKappa二0.63,withhighconsistency；correctdiagnosisratesofcolposcopycervicalbiopsyandLEEPpostoperativepathologycheckwere82.30%and68.43%respectively.InthediagnosisofCINII/III,theaccuratediagnosisrateswererespectively7
8、9.63%and81.48%；misseddiagnosisrateswererespectively20.37%and18.52%；consistencyanalysisoncolposcopiccervicalbiopsyandLEEPpostoperativepathologicexaminationindiagnosisofCINII/IIIandcarcinomashowedthatKvaluewere
