Objective:To discuss the complete coincidence rate of pathology of cervical biopsy and hysterectomy or radical hysterectomy in cervical cancer patients and its clinical significance.Methods:Analyzed the clinical pathological data of 1 872 cervical cancer patients who were treated in Shengjing Hospital retrospectively.The 1 818 patients were accorded with inclusion criteria were statistically analyzed.Results:1 818 cases included 1 575 patients with squamous cell carcinoma (SCC),173 patients with adenocarcinoma (AC),53 patients with adenosquamous carcinoma (ASC),17 patients with other pathological types.In 1 818 patients,there were 1 487 patients whose pathological results of cervical biopsy were consistent with the results after hysterectomy or radical hysterectomy,the total coincidence rate was 81.8%.816 patients did the cervical biopsy and pathological examination in our hospital,1 002 patients did the cervical biopsy in the other hospital and did the pathologic consultation in our hospital.The coincidence rate of pathology of our hospital was 83.8%,the other hospital was 80.1%,the difference was statistically significant.The coincidence rates of SCC,AC,ASC and other pathological types of cervical cancer were respectively 86.7%,75.3%,40.7%,70.0% in our hospital,in the other hospital were respectively 82.0%,80.4%,26.9%,42.9%,there was statistically difference in the coincidence rate of SCC.The coincidence rate of the highly and moderately differentiated group were significantly higher than the poorly differentiated group,the coincidence rate of carcinoma in situ and stage Ia1 group was significantly lower than stage Ia2-IIb group.Conclusion:Missed diagnosis is possible to diagnose cervical cancer by cervical biopsy under colposcopy,especially for cervical cancer in situ and stage Ia1.It can improve the accuracy of preoperative diagnosis by the means of pathology consultation,and has great value in choosing proper clinical therapy.%目的:探讨宫颈癌术前阴道镜下宫颈活检病理与子宫全切或广切术后石蜡病理的符合率及其临床意义.方法:回顾性分析2012年1月-2015年5月就诊于中国医科大学附属盛京医院妇科行手术治疗的1 872例宫颈恶性肿瘤患者的临床病理资料.对符合纳入标准的1 818例患者进行统计研究.结果:1 818例患者中,宫颈鳞状细胞癌1 575例,宫颈腺癌173例,宫颈腺鳞癌53例,其他病理类型17例.1 818例患者中,宫颈活检病理与子宫全切或广切术后石蜡病理结果相符合的为1 487例,总符合率为81.8%.其中816例直接于我院行宫颈活检及病理组织检查,1 002例于外院行宫颈活检后于我院行病理切片会诊,我院宫颈活检病理诊断符合率为83.8%,外院为80.1%,差异有统计学意义.我院宫颈鳞癌、腺癌、腺鳞癌及其他少见病理类型诊断符合率为86.7%、75.3%、40.7%、70.0%;外院宫颈鳞癌、腺癌、腺鳞癌及其他少见病理类型诊断符合率为82.0%、80.4%、26.9%、42.9%,宫颈鳞癌诊断符合率两者之间差异有统计学意义.外院与我院高-中分化组宫颈癌的活检病理诊断符合率均明显高于低分化组,差异有统计学意义.原位癌-Ia1期宫颈癌的宫颈活检病理诊断符合率均明显低于Ia2期-IIb期,差异有统计学意义.结论:阴道镜下宫颈活检有漏诊宫颈癌的可能,尤其是原位癌-Ia1期宫颈癌;完善上级医院病理会诊可提高术前诊断的准确性,对于临床上治疗方案的选择具有重要价值.
展开▼
