探讨宫颈上皮内瘤变采用冰冻病理与石蜡病理诊断比较.docVIP

精品论文 参考文献 探讨宫颈上皮内瘤变采用冰冻病理与石蜡病理诊断比较 大庆油田总医院 163000 　　摘要：目的：研究并探讨宫颈上皮内瘤变患者冷刀锥切术中冰冻检查（frozen section examination，FSE）同术后石蜡病理检查（paraffin section examination，PSE）诊断准确度的差异。方法：回顾性分析2009年1月至2013年5月初诊为CINⅡ～Ⅲ于我院行冷刀锥切术218例患者资料。所有患者术中行冰冻病理，术后进行石蜡病理检查。对比研究FSE与PSE对宫颈病变检出情况差异。结果：1.冰冻病理与石蜡病理的总诊断符合率为89%（195/218），FSE的病变检出率低于PSE，但差异无统计学意义。Kappa值一致性检验提示二者具有较好的一致性。2.大范围的冰冻标本不能提高FSE对宫颈病变的检出率。结论：宫颈上皮瘤变患者术中行冰冻病理检查对宫颈病变确诊具有一定临床价值。病理医生对冰冻病理熟悉程度是影响冰冻病理准确度的一个重要原因。通过准确取材，提高制片水平等能提高冰冻病理诊断准确度。 　　关键词：宫颈上皮内瘤变；冰冻病理；石蜡病理 　　[Abstract]Objective：To study and explore the frozen section examination of cervical intraepithelial neoplasia in patients with cold knife conization（frozen in section examination，FSE）with postoperative paraffin pathological examination（paraffin section，examination，PSE）diagnostic accuracy difference.Methods：a retrospective analysis was performed in 218 patients with CIN from January 2009 to May 2013 in our hospital.Intraoperative frozen pathology was performed in all patients，and the pathological examination was performed after operation.Comparative study of FSE and PSE in the detection of cervical lesions.Results：the total diagnostic accordance rate was 89%（195/218），1（）.The detection rate of PSE was lower than that of FSE，but the difference was not statistically significant.The consistency test of Kappa value indicated that the two had good consistency.2 a large range of frozen specimens can not improve the detection rate of FSE for cervical lesions.Conclusion：Frozen pathological examination of cervical lesions in patients with cervical intraepithelial neoplasia has a certain clinical value.The degree of familiarity with frozen pathology is one of the important reasons for the accuracy of frozen pathology.Through accurate sampling，improve the level of production and so on can improve the accuracy of frozen pathological diagnosis. 　　[Key words]cervical intraepithelial neoplasia；frozen pathology；paraffin pathology 　　宫颈上皮内瘤变是与宫颈浸润癌密切相关的一组癌前病变，它反映宫颈癌发生发展中的连续过程[1]。CINⅢ是向宫颈癌转化的最后阶段，其发展