Ronk D A, Jimerson G K, Merrill J A
Obstet Gynecol. 1977 May;49(5):581-6.
The results from cytologic, colposcopic, and histologic studies in 376 patients are analyzed and compared to previous reports. Cytologic results correlated within 1 degree of the histologic diagnosis in only 67% of cases. Colposcopic impression correlated with the final histologic diagnosis in 78% of cases. Directed biopsies were exceedingly accurate (99.3%) when the entire transformation zone was visualized. When the entire zone was not visualized, 7 cases of invasive carcinoma were discovered among 59 cone biopsies. It is concluded that cytology should be used only as a screening tool and colposcopy as a directional aid in obtaining biopsies and defining the need for endocervical curettage. When the entire zone is visualized, directed biopsies are dependable and cone biopsies may be avoided. When the upper zone is not visualized and the endocervical canal is involved by significant dysplasia or carcinoma in situ as diagnosed by directed biopsies and/or endocervical curettage, cone biopsy is mandatory prior to definite therapy.
对376例患者的细胞学、阴道镜检查和组织学研究结果进行了分析，并与之前的报告进行了比较。细胞学结果与组织学诊断在1级范围内相符的病例仅占67%。阴道镜检查印象与最终组织学诊断相符的病例占78%。当整个转化区可视时，直接活检极其准确（99.3%）。当整个区域不可视时，在59例锥形活检中发现了7例浸润癌。结论是，细胞学仅应用作筛查工具，阴道镜检查用作获取活检和确定是否需要宫颈管刮除术的定向辅助手段。当整个区域可视时，直接活检可靠，可避免进行锥形活检。当上部区域不可视且根据直接活检和/或宫颈管刮除术诊断宫颈管有明显发育异常或原位癌时，在明确治疗之前必须进行锥形活检。
