Value Of Colposcopy In The Diagnosis And Treatment Of Cervical Squamous Intraepithelial Lesions

BackgroundCervical cancer(Cervical cancer,CC)is a serious threat to women’s health due to its high morbidity and mortality.Early screening for diagnosis and active treatment of cervical squamous intraepithelial lesions are key to prevent the development of cervical cancer.Colposcopy is particularly important in the "three steps" screening mode of cervical cancer,directly affect the diagnosis and treatment of patients,but at present,the level of colposcopy in hospitals in China is uneven,the diagnostic value is not the same,and more clinical experience is lacking.Therefore,the value of colposcopy in the diagnosis and treatment of cervical squamous intraepithelial lesions is a problem that needs to be paid attention to in clinical practice.ObjectiveTo explore the diagnostic and treatment value of colposcopy for cervical squamous intraepithelial lesions,and to analyze different surgical methods,aiming to summarize the experience and deficiency in the diagnosis and treatment of cervical squamous intraepithelial lesions,so as to better serve patients.MethodsThe data of 296 patients with cervical squamous intraepithelial lesions who underwent colposcopy and cervical biopsy and finally underwent cervical conectomy or total hysterectomy from July 2020 to July 2021 in the First Affiliated Hospital of Xinxiang Medical College were retrospectively analyzed.By self-control,the colposcopy diagnosis,cervical biopsy pathology and postoperative pathology of the included patients were analyzed,and the postoperative pathology,margin and reoperation of different surgical methods were statistically analyzed.Result1.The diagnostic coincidence rate between colposcopy biopsy results and postoperative pathological results was 80.74%,and the diagnostic concordance rate between Low-grade squamous intraepithelial lesion(LSIL)and postoperative pathology was 73.68%,the coincidence rate of High-grade squamous intraepithelial lesion(HSIL)was81.78%.There was no statistical significance in the diagnosis coincidence rate between the two diagnosed coincidence rates(P >0.05).The sensitivity,specificity,positive predictive value and negative predictive value of HSIL under colposcope were 97.30%,43.24%,83.72% and 84.21% respectively.2.The total coincidence rate of the diagnosis of the colposcopy image and biopsy pathology was 84.12%.The diagnosis of the colposcopy image was LSIL or lighter,the coincidence rate with the cervical biopsy pathology was 43.08%,the diagnosis of the colposcopy image was HSIL or worse,the coincidence rate was 95.67%,the difference between the two diagnosed coincidence rates was statistically significant(P <0.05).3.The overall coincidence rate between the proposed colposcopy images and the postoperative pathological results was 86.82%.including 76.92% for LSIL or lighter,and89.61% for HSIL or worse,the difference between the two diagnosed coincidence rates was statistically significant(P <0.05).The coincidence rates of the diagnosis of the colposcopy image and final pathology were 94.80% and 74.80%,respectively,in patients with type I/II and III transformation zone,the difference between the two diagnosed coincidence rates was significant(P <0.05).The sensitivity of HSIL or worse was 93.24%,specificity of67.56%,positive predictive value of 89.61%,and negative predictive value of 76.92%.4.The coincidence rate between biopsy pathology and postoperative pathology of patients undergoing cervical conization was 82.57%,and the coincidence rate between biopsy pathology and postoperative pathology of patients undergoing total hysterectomy was 75.64%.There was no statistical significance in the coincidence rate between the two different surgical methods(P > 0.05).Conclusion1.Colposcopy cervical biopsy has comparable diagnostic value for HSIL and LSIL,has high consistency with the diagnosis of postoperative pathology,and has high sensitivity for the diagnosis of HSIL.2.Colposcopy image has high diagnostic value for HSIL or worse,but the diagnostic level of LSIL or lighter needs to be further strengthened.3.The type of cervical conversion zone affects the diagnostic accuracy of colposcopy,and the diagnostic coincidence rate of patients with cervical type I / II transformation zone was significantly higher than that in type III.