Value of Endocervical Curettage in Detection of High-grade Cervical Squamous Intraepithelial Lesion
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摘要:目的
探讨子宫颈管搔刮术（ECC）对宫颈高级别鳞状上皮内病变（HSIL）的检出价值。
方法回顾性分析678例具有完整病例资料患者的临床特点和阴道镜特征。
结果678例患者中仅经子宫颈活检确诊HSIL者391例（57.67%），仅ECC确诊HSIL者7例（1.03%），差异有统计学意义（P < 0.001）；ECC诊断为HSIL 287例（42.33%，含子宫颈活检阳性和阴性病例），子宫颈活检诊断为HSIL 671例（98.97%，含ECC阳性和阴性病例），差异有统计学意义（P < 0.001）。1型+2型转化区中ECC阳性68例（33.33%, 68/204），3型转化区中ECC阳性247例（52.11%, 247/474），差异有统计学意义（P < 0.001）。≥45岁与 < 45岁者ECC阳性率分别为145例（55.13%, 145/263）和170例（40.96%, 170/415），两者比较，差异有统计学意义（P < 0.001）。
结论子宫颈活检在HSIL的检出中占主导地位，ECC只能作为子宫颈活检的补充；年龄≥45岁或阴道镜检查为3型转化区时应该关注子宫颈管内病变。
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关键词:
- 子宫颈搔刮术 /
- 宫颈高级别鳞状上皮内病变 /
- 宫颈癌 /
- 液基细胞学 /
- HPV
Abstract:ObjectiveTo explore the value of endocervical curettage (ECC) in the detection of high-grade cervical squamous intraepithelial lesion (HSIL).
MethodsWe retrospectively analyzed the clinical features and colposcopical characteristics of 678 female patients with complete clinical data.
ResultsAmong 678 cases, 391 cases were confirmed by cervical biopsy only and 7 cases by ECC only (57.67% vs. 1.03%, P < 0.001). ECC checked out 287 HSIL patients (42.33%, including cervical biopsy positive and negative cases) and cervical biopsy checked out 671 HSIL cases (98.97%, including ECC positive and negative cases). There were 68 positive ECC cases in the conversion area of Type 1+Type 2 and 247 positive ECC cases in the conversion area of Type 3(33.33% vs. 52.11%, P < 0.001). The positive rates of ECC in patients≥45 years old and < 45 years old were 145 and 170, respectively (55.13% vs. 40.96%, P < 0.001).
ConclusionThe cervical biopsy plays a dominant role in the detection of HSIL, and ECC can only be used as a supplement to it. Female patients older than 45 years or with Type 3 transformation zone examined by colposcopy should be concerned with cervical lesions.
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Competing interests: The authors declare that they have no competing interests.作者贡献：王琦：课题设计，资料收集及数据处理，撰写论文涂开家：课题指导，质控及审校，论文修改巢金珍、曾莹、傅佳：资料收集及数据处理敖梅红：课题指导，质控及审校，论文修改
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表 1 细胞学和HR-HPV联合检测及单一检测的检出率比较(n=678)
Table 1 Detection rates of cytology, HR-HPV and their combination (n=678)
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表 2 子宫颈活检和子宫颈管搔刮术检出病理结果比较
Table 2 Pathological results of cervical biopsy and endocervical curettage
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