[1]张雪耿力**游珂郭艳利梁华茂.绝经后患者阴道镜活检诊断准确性的临床评估[J].中国微创外科杂志,2025,01(7):411-415.
　Zhang Xue,Geng Li,You Ke,et al.Clinical Evaluation of the Diagnostic Accuracy of Colposcopic Biopsy in Postmenopausal Patients[J].Chinese Journal of Minimally Invasive Surgery,2025,01(7):411-415.
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绝经后患者阴道镜活检诊断准确性的临床评估()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2025年7期
页码:
411-415
栏目:
临床研究
出版日期:
2025-07-30

文章信息/Info

Title:
Clinical Evaluation of the Diagnostic Accuracy of Colposcopic Biopsy in Postmenopausal Patients
作者:
张雪耿力**游珂郭艳利梁华茂
(北京大学第三医院妇产科，北京100191)
Author(s):
Zhang Xue;  Geng Li;  You Ke;  et al.
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
关键词:
宫颈病变; 人乳头状瘤病毒; 绝经后; 阴道镜活检
Keywords:
Cervical lesions; Human papilloma virus; Postmenopause; Colposcopy biopsy
文献标志码:
A
摘要:
目的探讨绝经后患者阴道镜活检的诊断准确性。方法回顾性分析2016年1月~2020年12月我院阴道镜门诊1049例绝经后患者的临床资料，对其中131例阴道镜活检诊断为宫颈高级别鳞状上皮内病变及浸润癌并行手术治疗的患者，以术后病理为金标准进行一致性分析。结果阴道镜活检准确率93.9%(123/131)，敏感性63.6%(14/22)，特异性100.0%(109/109)，漏诊率36.4%(8/22)。按年龄进行分组，55~65岁组和>65岁组Ⅲ型转化区比例明显大于44~54岁组(χ2=11.301，P=0.001； χ2=5.639，P=0.018)。8例漏诊浸润癌(ⅠA1期3例，ⅠA2期1例，ⅠB1期4例)，年龄49~67岁，平均60岁；5例为Ⅲ型转化区，3例为Ⅱ型转化区；7例病灶面积累及1~2个象限，1例病灶累及3个象限。结论阴道镜活检有一定的漏诊率,对于绝经后患者，应多点活检并联合宫颈管搔刮术提高诊断准确性。
Abstract:
ObjectiveTo Explore the diagnostic accuracy of colposcopic biopsy in postmenopausal patients.MethodsA retrospective analysis was performed on the clinical data of 1049 postmenopausal patients admitted to the colposcopy clinic of our hospital from January 2016 to December 2020. Among them, 131 patients who were diagnosed with highgrade cervical squamous intraepithelial lesions or invasive carcinoma by colposcopic biopsy and underwent surgery were selected. Postoperative pathology was used as the gold standard for consistency analysis.ResultsThe accuracy rate of colposcopic biopsy was 93.9% (123/131), with a sensitivity of 63.6% (14/22), a specificity of 100.0% (109/109), and a missed diagnosis rate of 36.4% (8/22). When grouped by age, the proportion of type Ⅲ transformation zones in the 55-65 years old group and > 65 years old group was significantly higher than that in the 44-54 years old group (χ2=11.301, P=0.001; χ2=5.639, P=0.018). Eight cases of missed invasive carcinoma (3 cases of stage ⅠA1, 1 case of stage ⅠA2, and 4 cases of stage ⅠB1) aged 49-67 years old (mean, 60 years old). Among them, 5 cases had type Ⅲ transformation zones and 3 cases had type Ⅱ transformation zones. Lesions involved 1-2 quadrants in 7 cases and 3 quadrants in 1 case.ConclusionsColposcopic biopsy has a certain missed diagnosis rate. For postmenopausal patients, multiplepoint biopsy combined with endocervical curettage should be performed to improve diagnostic accuracy.

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备注/Memo

备注/Memo:
基金项目：中西医协同“旗舰”医院试点单位“博采合璧”项目（2404-01-14）**通讯作者，Email:gengli57@163.com
更新日期/Last Update: 2025-09-18