Analysis Of The Coincidence Rate Of Diagnosis Between Colposcopy And Surgery In Cervical Lesions

Background and ObiectivesCervical cancer(CC)is one of the most common malignant tumors of the female reproductive system with high morbidity and mortality worldwide.However,cervical cancer is a preventable tumor,and the third-grade prevention can reduce the incidence and mortality of cervical cancer.High-risk human papillomavirus(HR-HPV)persistent infection or repeated infection is the main cause of cervical squamous intraepithelial lesion(SIL)and cervical cancer,from HR-HPV infection to SIL and then progress to CC,the time may be as long as about ten years.In this long period of time,early detection of SIL and timely treatment of high-grade cervical lesions play an important role in cervical cancer prevention.Colposcopy and cervical biopsy in the three-step screening of cervical cancer are particularly critical for the diagnosis of SIL.However,at present,the levels of colposcopy in hospitals across China are uneven,lacking more clinical data and clinical experience.This article will compare the pathology of colposcopy,colposcopy biopsy and LEEP,CKC or hysterectomy,and explore the value of colposcopy for cervical lesions,screening for cervical cancer and Clinical data are provided for the diagnosis and treatment of cervical lesions.Materials and MethodsCollecting colposcopy at the gynecological clinic of the Second Affiliated Hospital of Zhengzhou University from January 2016 to January 2018,and performing a colposcopy cervical biopsy.According to the medical history,cervical cytology results,colposcopy images and pathological results of cervical biopsy,544patients were treated with LEEP or CKC or hysterectomy.The patient’s age,maternal birth,contraceptive methods,indications for colposcopy,colposcopy findings,colposcopy biopsy pathology,postoperative pathology were retrospectively analyzed.Insufficient and over-reported colposcopy,in-situ upgrade and degradation of colposcopy biopsy were summarized.The selection of surgical methods and postoperative follow-up results were statistically analyzed.According to the American Society of Colposcopy and Cervical Pathology(ASCCP)standardized terminology for graphic recording,colposcopy evaluation,colposcopy diagnosis,colposcopy direct colposcopic biopsy,if necessary,cervical Tube scraping,pathological examination of the tissue taken.According to the 2014WHO classification of female genital tumors,SIL is divided into LSIL and HSIL,LSIL is equivalent to CIN1,and HSIL is equivalent to CIN2 and CIN3.CIN2 is combined with p16 negative according to LSIL treatment,and CIN2 combined with p16 positive is treated with HSIL.Data were analyzed by using SPSS 21.0 software.The count data were tested byχ~2 test.P<0.05indicates that the difference isstatistically significant.Results1.The age distribution of 544 patients in this study was 20-71 years old,the average age was 34.82±5.34 years old,the peak age was 30-40 years old,the pregnancy was 2.7±0.4 times,the output was 1.6±0.4 times,and the contraceptive contraception was 92 cases.There were 84 cases of oral contraceptive contraception,282 cases of condom contraception,and 86 cases of no contraception.2.According to the colposcopy image and the overall impression of the history of the vaginal mirror,8 cases were diagnosed as cervical inflammation,89 cases were diagnosed as LSIL cases,442 cases were diagnosed as HSIL,and 5 cases were diagnosed as cervical cancer.Taking postoperative pathology as the reference standard,the overall coincidence rate of the colposcopy based on the overall impression of colposcopy images and medical history was 81.43%,the over-diagnosis rate was 15.63%,the deficiency rate was 2.94%,and the coincidence rate of cervicitis was 62.50%.The coincidence rate of LSIL was 71.91%,the coincidence rate of HSIL was 83.71%,and the coincidence rate of cervical cancer was 80.00%.The coincidence rate of LSIL and the following diagnosis of cervical lesions with HSIL and above was Chi-square test,χ2=8.28,P<0.05.There was a statistically significant difference in the coincidence rate between the two.The colposcopy biopsy pathology was taken as the reference standard,the overall coincidence rate was 87.87%;the colposcopy over-diagnosis rate was 5.88%,and the diagnostic deficiency rate was6.25%.The coincidence rate of cervicitis was 62.50%,the coincidence rate of LSIL was 64.04%,the coincidence rate of HSIL was 93.21%,and the coincidence rate of cervical cancer was 80.00%.For LSIL and below and HSIL and above.Cervical lesions were diagnosed according to the rate of Chi-square test,χ2=65.52,P<0.05,the difference between the two diagnosed coincidence rates was statistically significant.3.Colposcopy biopsy was diagnosed as 6 cases of cervical inflammation,89cases of LSIL were diagnosed,445 cases of HSIL were diagnosed,and 4 cases of cervical cancer were diagnosed.Taking postoperative pathology as the reference standard,the overall coincidence rate of colposcopy biopsy was 84.93%,postoperative pathological progression accounted for 0.88%,postoperative pathological degradation accounted for 13.60%,cervicitis diagnostic coincidence rate was 66.67%,and LSIL diagnostic coincidence rate was 85.39%.The coincidence rate of HSIL diagnosis was 85.84%,and the coincidence rate of cervical cancer diagnosis was 100%.The coincidence rate of LSIL and the following diagnosis of cervical lesions with HSIL and above was Chi-square test,χ2=0.20,P>0.05.There was no significant difference in the diagnostic coincidence rate between the two.Conclusions1.The colposcopy diagnosis and postoperative pathology,colposcopy biopsy pathological diagnosis have higher consistency,and the coincidence rate of the proposed HSIL is higher than LSIL.2.The coincidence rate of pathological diagnosis of colposcopy biopsy and postoperative pathological diagnosis has a high consistency.3.Colposcopy has a high value in the diagnosis of cervical lesions.