Pajtler Marija, Audy-Jurković Silvana, Ovanin-Rakić Ana, Makarović Zvonimir, Milojković Miodrag, Ljubojević Nikola
Department of Clinical Cytology, University Hospital, Osijek, Osijek, Croatia.
Coll Antropol. 2003 Jun;27(1):239-46.
The main objective of work was to determine a diagnostic value of cytology and colposcopy as a method of screening and differential diagnosis, as well as to determine the relative value of some colposcopic features of squamous and glandular cervical intraepithelial lesions. Cytological diagnosis and colposcopy findings is compared with histological ones for 187 patients with intraepithelial lesions (142 squamous and 45 glandular ones with or without squamous components) and determined the sensitivity and positive predictive value of cytology and colposcopy, including the types of colposcopic abnormalities associated with squamous/glandular intraepithelial lesions. The sensitivity of cytology as a screening method for SIL (squamous intraepithelial lesions) is 89% and for GIL (glandular intraepithelial lesions) 98%. Positive predictive value of differential cytology for SIL is 59% and for GIL 53%. Sensitivity of colposcopy for both lesions' type is 87%. Acetowhite epithelium occurs for more often with SIL, whereas atypical vessels and unequal, dilated gland openings with GIL (p < 0.05). Cytology and colposcopy as screening methods have a high sensitivity. Nevertheless, cytology is far more accurate in determining differential diagnosis of SIL than GIL and some colposcopy abnormalities suspicious of GIL should be further tested in praxis.
该研究的主要目的是确定细胞学和阴道镜检查作为筛查和鉴别诊断方法的诊断价值，以及确定宫颈鳞状上皮和腺上皮内病变的一些阴道镜特征的相对价值。将187例上皮内病变患者（142例鳞状上皮病变和45例腺上皮病变，有或无鳞状成分）的细胞学诊断和阴道镜检查结果与组织学结果进行比较，确定细胞学和阴道镜检查的敏感性和阳性预测值，包括与鳞状/腺上皮内病变相关的阴道镜异常类型。细胞学作为SIL（鳞状上皮内病变）筛查方法的敏感性为89%，作为GIL（腺上皮内病变）筛查方法的敏感性为98%。鉴别细胞学对SIL的阳性预测值为59%，对GIL的阳性预测值为53%。阴道镜检查对两种病变类型的敏感性均为87%。醋酸白上皮在SIL中更常见，而非典型血管以及不等大、扩张的腺开口在GIL中更常见（p<0.05）。细胞学和阴道镜检查作为筛查方法具有较高的敏感性。然而，在确定SIL的鉴别诊断方面，细胞学比GIL更准确，一些怀疑GIL的阴道镜异常在实践中应进一步检查。
