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目的评估阴道镜多点活检诊断宫颈上皮内瘤变(CIN)的准确性,并进一步分析其误诊的可能相关因素。方法回顾性分析90例阴道镜下宫颈活检确诊为CIN并行宫颈锥切术患者临床病理资料,评估阴道镜多点活检诊断CIN的准确性,并筛选其误诊的相关因素。结果阴道镜多点活检与宫颈锥切术后组织病理诊断的准确率为58.89%(53/90),误诊率为41.11%(37/90)。经宫颈锥切术后病理诊断级别升高占21.11%(19/90),级别下降占25.56%(23/90);漏诊宫颈癌3例,占3.33%。发现阴道镜活检CIN合并腺体受累病变者与阴道镜下宫颈活检CIN的误诊发生显著相关(P<0.01)。结论阴道镜多点活检确诊CIN尚不完全可靠,存在误诊。宫颈锥切术可以弥补阴道镜多点活检的缺陷,明显降低CIN的误诊率。
Objective To evaluate the accuracy of colposcopy multipoint biopsy in the diagnosis of cervical intraepithelial neoplasia (CIN) and to further analyze the possible related factors of misdiagnosis. Methods Retrospective analysis of 90 cases of cervical biopsy confirmed by cervical biopsy CIN parallel cervical conization clinical and pathological data to assess the accuracy of multi-point biopsy colposcopy in the diagnosis of CIN, and screening for misdiagnosis related factors. Results The accuracy of histopathological diagnosis after colposcopy biopsy and cervical conization was 58.89% (53/90) and the rate of misdiagnosis was 41.11% (37/90). Pathological diagnosis of cervical conization increased by 21.11% (19/90), the level of decline accounted for 25.56% (23/90); missed diagnosis of cervical cancer in 3 cases, accounting for 3.33%. Found colposcopic biopsy CIN with gland involvement lesions and colposcopic cervical biopsy CIN misdiagnosis occurred significantly (P <0.01). Conclusion colposcopy biopsy confirmed CIN is not entirely reliable, there is misdiagnosis. Cervical conization can make up for colposcopy multi-point biopsy defects, significantly reduce the misdiagnosis rate of CIN.