Clinical Application Value Of Ultrasound-guided Cervical Aspiration Biopsy

Purpose:Colposcopic cervical biopsy is currently the most commonly used method for preoperative confirmation of cervical malignancy in clinical practice,but it still does not exclude the influence of factors such as deep lesion location and small lesion area resulting in failed or inadequate sampling,resulting in inaccurate preoperative pathology and affecting the choice of surgical plan or other treatment modalities.The aim of this study was to investigate the value of clinical application of trans-ultrasound-guided cervical aspiration biopsy,and to provide new ideas for improving the detection rate of cervical malignancies in clinical practice.Methods:A total of 117 patients with suspected cervical cancer who underwent ultrasound-guided cervical aspiration biopsy admitted to Shengjing Hospital of China Medical University from January 2018 to April 2022 were retrospectively analyzed,and firstly,the diagnostic efficacy of ultrasound-guided cervical aspiration biopsy and the factors affecting the diagnostic accuracy of ultrasound aspiration biopsy were analyzed;secondly,patients who underwent both colposcopic biopsy and ultrasound-guided aspiration biopsy were divided into colposcopic biopsy group and ultrasound aspiration biopsy group,and the diagnostic accuracy of the two groups was compared;finally,the differences in diagnostic accuracy between colposcopic biopsy group and ultrasound aspiration biopsy group were compared among different influencing factors.Results:1.117 patients with ultrasound-guided cervical aspiration biopsy were enrolled,including77 cases of malignant lesions,2 cases of suspected malignant lesions and 38 cases of benign lesions,and the total number of patients who matched the final clinical diagnosis was 109,including 77 cases of malignant lesions and 32 cases of benign lesions.The accuracy rate of trans-ultrasound-guided cervical aspiration biopsy for the diagnosis of cervical occupying lesions was 93.2%,including 90.6% sensitivity and 100% specificity for the diagnosis of cervical malignant lesions,with 100% positive predictive value and80.0% negative predictive value.The diagnostic accuracy of trans-ultrasound-guided cervical aspiration biopsy for the diagnosis of primary malignant tumors of the cervix was 92.3%.2.The diagnostic accuracy of ultrasound-guided cervical aspiration biopsy was correlated with lesion size,growth pattern and clinical stage,in which the diagnostic accuracy of ultrasound aspiration biopsy was higher for primary malignant tumors of the cervix with lesion size >2cm≤4cm,growth pattern of endogenous type and clinical stage IIB and above,and the difference was statistically significant.3.A total of 56 cases underwent both colposcopic biopsy and ultrasound aspiration biopsy,and the diagnostic accuracy of colposcopic biopsy was 50.0% for 28 malignant cases,10 suspected malignant cases and 18 benign cases;ultrasound aspiration biopsy diagnosed 50 malignant cases,2 suspected malignant cases and 4 benign cases,and the diagnostic accuracy of ultrasound aspiration biopsy was 89.3%;the diagnostic accuracy of ultrasound aspiration biopsy was higher than that of The diagnostic accuracy of ultrasound aspiration biopsy was higher than that of colposcopic biopsy,P<0.05,and the difference was statistically significant.4.In terms of lesion size,the diagnostic accuracy of ultrasound aspiration biopsy for patients with primary malignant tumors of the cervix >2cm≤4cm was 95.5%,which was higher than that of colposcopic biopsy by 50.0%,and the difference was statistically significant;the diagnostic accuracy of ultrasound aspiration biopsy for patients with cervical cancer >4cm was 92.9%,which was higher than that of colposcopic biopsy by53.6% The difference was statistically significant.5.In terms of growth mode,the diagnostic accuracy of ultrasound aspiration biopsy in patients with endogenous cervical primary malignancy was 93.1%,higher than that of colposcopic biopsy,which was 44.8%,and the difference was statistically significant;the diagnostic accuracy of ultrasound aspiration biopsy in patients with exogenous cervical cancer was 91.3%,higher than that of colposcopic biopsy,which was 60.9%,and the difference was statistically significant.6.In terms of clinical stage,the diagnostic accuracy of ultrasound aspiration biopsy for patients with primary cervical malignancies in stages IA2～IIA2 was 91.7%,which was higher than that of colposcopic biopsy by 50.0%,and the difference was statistically significant;the diagnostic accuracy of ultrasound aspiration biopsy for patients with cervical cancer in stage IIB and above was 93.3%,which was higher than that of colposcopic biopsy by 53.3% The difference was statistically significant.Conclusions:Trans-ultrasound-guided cervical aspiration biopsy has the advantage of high diagnostic accuracy for primary malignant tumors of the cervix of endophytic type,lesions >2cm≤4cm and clinical stage IIB and above.When the results of colposcopic biopsy do not match with other adjuvant findings or cannot provide a basis for subsequent treatment,ultrasound-guided cervical aspiration biopsy can obtain a clear pathological diagnosis,improve the detection rate of cervical malignant lesions,correct or supplement the pathological diagnosis of colposcopic biopsy,and can be a complementary examination to colposcopic biopsy.