TCT、阴道镜下活检和LEEP对CIN诊断价值的比较

目的：评价TCT检查、阴道镜活检和LEEP活检在宫颈上皮内瘤变（ClN）诊断中的价值，比较其差异。方法：对324例经TCT加阴道镜下活检诊断为CIN的患者进一步行LEEP，采用对比研究TCT、阴道镜下活检和IEEP活检病理结果。结果：TCT检查与阴道镜活检诊断结果的完全符合率为65．1％，TCT结果与LEEP活检病理学诊断结果的完全符合率为69．4％，诊断过度11．4％，诊断不足18．5％。阴道镜下宫颈活检结果与LEEP活检病理学诊断结果的完全符合率为68．2％，诊断过度21．9％，诊断不足9-3％，后两种方法的诊断结果差异有统计学意义（P〈O．01）。结论：TCT是辅助诊断CIN的有效方法；单独阴道镜下活检诊断CIN的准确性尚不够理想，阴道镜下活检不能替代LEEP活检；TCT诊断CIN者在初次治疗时可用LEEP一次完成诊断和治疗。

Comparison of TCT, Colposcopically Directed Biopsy and Loop Electrosurgical Excision Procedure in Diagnosis of Cervical Intraepithelial Neoplasia

To evaluate the significance of the check of TCT, colposcopically directed biopsy and cervical loop electrosurgical excision procedure （LEEP） in diagnosis of cervical intraepithelial neoplasia （CIN）, and to compare the differences of the three kinds of methods in diagnosing CIN. Methods： LEEP was performed on 324 patients who diagnosed as CIN by TCT plus colposcopically directed biopsy. Results of diagnosing CIN by TCT, colposcopically directed biopsy and LEEP was evaluated and compared. Results：The consistence rate of the diagnosis by TCT and that by colposcopically directed biopsy was 65.1%. The diagnosis of patients by TCT was consistent with that by LEEP as confirmed by pathologic diagnosis with a consistence rate of 69.4%, the over diagnosis rate was 11.4% and the underdiagnosis rate was 18.5 %. The consistence rate of the diagnosis by colpcecepically directed biopsy and that by LEEP was 68.2%, the over diagnosis rate 21.9% and the underdiagnosis rate 9.3 %. The difference between the diagnosis by colposcopically directed biopsy and that by LEEP was statistically significant （P〈0.01）. Conclusions： TCT is an effective assisting method for diagnosing CIN. The accuracy of diagnosing CIN with colposcopically directed biopsy is still unsatisfied. Cervical conization by LEEP can not be instead by colpescopically directed biopsy. It is suggested that LEEP could be a better choice for the first treatment for patients with diagnosis of CIN by TCT.