Cheng Yi-fan, Wang Xin-yu, Lü Wei-guo, Cheng Xiao-dong, Xie Xing
Obstetrics & Gynecology Hospital Affiliated to College of Medicine, Zhejiang University, Hangzhou 310006, China.
Zhonghua Yi Xue Za Zhi. 2010 Jul 20;90(27):1882-5.
To assess the accuracy of colposcopy-assisted biopsy for the diagnosis of cervical intraepithelial neoplasia I (CIN(1)) and to reappraise the correlative factors of missed CIN(2+) in low-grade SIL(squamous intraepithelial lesion)pathologically diagnosed by colposcopy-assisted biopsy.
A total of 274 women with CIN(1) diagnosed by colposcopy-assisted biopsy and missing scheduled follow-up thus elected to undergo loop electrosurgical excisional procedure (LEEP). Epidemiological data and cervical cytology, high risk human papillomavirus (HR-HPV) detection and colposcopy with directed biopsy and endocervical curettage if necessary prior to LEEP were reviewed and correlation of missed CIN(2+) and all the above factors analyzed.
Among these patients, 85 cases (31.0%) of CIN(2+) were detected. Univariate analysis showed that poor cervical cytology before colposcopy, unsatisfactory colposcopy and positive HR-HPV detection were risk factors of missed CIN(2+) in low-grade SIL pathologically diagnosed by colposcopy-assisted biopsy. Multivariate logistic analysis showed that whether colposcopic examination was satisfactory or not and cervical cytology before colposcopy were independent risk factors of missed CIN(2+) in low-grade SIL pathologically diagnosed by colposcopy-assisted biopsy (OR: 2.06 and 4.67 respectively).
The accuracy of colposcopy-assisted biopsy for the diagnosis of CIN(1) remains poor. Whether colposcopic examination is satisfactory or not and cervical cytology before colposcopy are independent risk factors of missed CIN(2+) in low-grade SIL pathologically diagnosed by colposcopy-assisted biopsy.
评估阴道镜辅助活检诊断宫颈上皮内瘤变I（CIN1）的准确性，并重新评估经阴道镜辅助活检病理诊断为低级别鳞状上皮内病变（SIL）时漏诊CIN2+的相关因素。
共有274例经阴道镜辅助活检诊断为CIN1且未按计划进行随访的女性选择接受环形电切术（LEEP）。回顾了LEEP术前的流行病学数据、宫颈细胞学检查、高危型人乳头瘤病毒（HR-HPV）检测、阴道镜检查及必要时的靶向活检和宫颈管刮术，并分析漏诊CIN2+与上述所有因素的相关性。
在这些患者中，检测到85例（31.0%）CIN2+。单因素分析显示，阴道镜检查前宫颈细胞学结果不佳、阴道镜检查不满意以及HR-HPV检测呈阳性是经阴道镜辅助活检病理诊断为低级别SIL时漏诊CIN2+的危险因素。多因素logistic分析显示，阴道镜检查是否满意以及阴道镜检查前的宫颈细胞学结果是经阴道镜辅助活检病理诊断为低级别SIL时漏诊CIN2+的独立危险因素（OR分别为2.06和4.67）。
阴道镜辅助活检诊断CIN1的准确性仍然较差。阴道镜检查是否满意以及阴道镜检查前的宫颈细胞学结果是经阴道镜辅助活检病理诊断为低级别SIL时漏诊CIN2+的独立危险因素。
