Colposcopic Cervical Biopsy In The Diagnosis Of Cervical Lesions (Clinical Analysis Of 500 Cases)

Objective:To investigate the diagnostic value of the usage of colposcopy by colposcopy diagnosis, cytology and histopathology diagnosis of contrast in cervical lesions. Methods: Retrospective analysis of March to December 2009 in Dalian maternity hospital gynecology clinic cytology cervical abnormalities or abnormal visual observation, received colposcopy and colposcopy cervical biopsy patients under direct vision of 500 cases ,to compare and analyze the results of cytology, colposcopy and histopathology diagnosis.Rusults:(1)500 cases of cervical colposcopic biopsy, histopathological diagnosis of 290 cases were inflammatory, CINⅠ(cervical intraepithelial neoplasia gradeⅠ) in 65 cases CINⅡ76 cases﹑CINⅢ54 cases﹑15 cases of cervical cancer; colposcopy diagnosed 202 cases cervicitis, histopathology 188 cases, compliance rate 93.1%; histopathological diagnosis of CIN14 cases of missed diagnosis rate was 6.9%; Colposcopy diagnosed low-grade squamous intraepithelial lesions (LSIL) 154 cases, including histopathological diagnosis CINⅠ40 cases, the compliance rate was 26.0%, a high degree of lesions (CINⅡ/ CINⅢ) 27 cases of missed diagnosis rate was 17.5%; colposcopy to be Diagnosis of squamous intraepithelial lesions (HSIL) 126 cases of pathological diagnosis CINⅡ/ CINⅢ95 cases, the rate was 75.4%, 1 case of cervical cancer, missed diagnosis rate was 0.8%.(2)Thinprep cytology test(TCT) were negative results in 18 cases, histopathological diagnosis CINⅠ3 cases (16.7%), CINⅢ1 case (5.6%); TCT result is a total of 78 cases of ASCUS, of which histopathological diagnosis CINⅠ9 cases (11.5%), CINⅡ11 cases (14.1%), CINⅢ6 cases (7.7%),TCT is ASC-L/LSIL 61 cases, including histopathological diagnosis CINⅡ9 cases (14.8%),CINⅢ1 cases (1.6%).the misdiagnosis rate of CIN was 38.2% (60/157) in NILM, ASCUS, ASC-L/LSIL; ASCUS, NILM in the rate of missed diagnosis CIN 31.3% (30/96); NILM in the rate of missed diagnosis CIN 22.2% (4 / 18).(3) 500 cases of patients receiving the human papillomavirus (HPV) genotyping 56 cases,HPV type of the calculation of a total of 72 subtypes of passengers,respectively,16 type (24 cases),18 type (2 cases),31 type (2 Cases),39 type (2 cases),45 type (1 case),51 type (1 case),52 (12),53 type (3 cases),56 type (2 cases),type 58 ( 9 cases ),66 type (2cases) and 68type(3 cases), otherwise low-risk type 11 type (2 cases). Histopathological diagnosis of CIN which in 42 cases,including a high degree of lesions (CINⅡ/ CINⅢ) in 25 cases,HPV type 16 subtypes were 40.5%,52 types 14.3%,58 type 11.9%,33 type 9.5%,18 type 4.8%,56 and 68 type each 2.4%.Conclusions:(1)The colposcopic diagnosis of cervical high-grade squamous intraepithelial lession and cervical cancer have a higher sensitivity, with a relatively low sensitivity in the diagnosis of low-grade cervical lesions.(2)In this study, the overall rate of misdiagnosis in the TCT is 14.4% (40/277); TCT results were negative and ASCUS in 31.3% CIN rate of misdiagnosis, it should be effective use HPV testing and colposcopy and other screening measures to reduce misdiagnosis.(3) In this study, with a high degree of HPV-related lesions subtypes were 16﹑ 18﹑33﹑52﹑56﹑58﹑68 , so these subtypes should be increased attention.