CAJ | 학술논문

活检组织快速石蜡切片病理检查在子宫颈病变诊治中的应用
활검조직쾌속석사절편병리검사재자궁경병변진치중적응용
Application of pathological diagnosis by rapid paraffin sections for biopsy in the diagnosis and treatment of cervical diseases

万方数据

中华妇产科杂志中華婦產科雜誌 중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2011年 7期 516-520 ,共5页

何丽%李莉%张廷国%张匀%乔云波%崔保霞%姜洁%王波%杨兴升%张友忠%ZHENG Wen-xin%孔北华

하려%리리%장정국%장균%교운파%최보하%강길%왕파%양흥승%장우충%ZHENG Wen-xin%공북화

宫颈上皮内瘤样病变%活组织检查%石蜡包埋宮頸上皮內瘤樣病變%活組織檢查%石蠟包埋
궁경상피내류양병변%활조직검사%석사포매
Cervical intraepithelial neoplasia%Biopsy%Paraffin embedding

目的评价活检组织快速石蜡切片病理检查在宫颈病变诊治中的应用价值.方法选择2009年9月至2010年1月在山东大学齐鲁医院行宫颈癌筛查异常者(包括细胞学检查异常及高危型HPV持续阳性)共176例,随机分为两组.A组:87例,首先采用宫颈Belinson活检钳在阴道镜指示下行宫颈多点活检,然后利用超声组织处理仪和BT生物组织透明剂制作快速石蜡切片,行病理检查;B组:89例,在阴道镜指示下行官颈多点活检,制作常规石蜡切片,行病理检查.比较两组的切片质量、制片时间.对A、B组中诊断为宫颈上皮内瘤变(CIN)Ⅱ及以上病变、特殊情况的CIN Ⅰ患者行手术治疗,手术方式包括宫颈环形电极切除术(LEEP)、官颈冷刀锥切术(CKC)、子宫切除术或宫颈癌根治术,手术标本术后进行常规病理检查,当活检组织(包括快速或常规)病理检查和术后标本常规病理检查结果不符时,以两者中诊断结果较重者为最终诊断,比较A、B组的活检组织病理检查结果与最终诊断的符合率.结果 A、B组切片质量均为满意或基本满意,能够满足诊断要求,切片合格率均为100%.A、B组的制片时间平均分别为40 min和1 d,两组比较,差异有统计学意义(P<0.05).A、B组中行手术治疗的患者分别为30、32例,其活检组织病理检查结果与最终诊断的符合率分别为93%(28/30)和9l%(29/32),两组比较,差异无统计学意义(P>0.05).结论活检组织快速石蜡切片病理检查诊断宫颈病变准确可靠、快速经济,有推广使用价值.
목적 평개활검조직쾌속석사절편병리검사재궁경병변진치중적응용개치.방법 선택2009년9월지2010년1월재산동대학제로의원행궁경암사사이상자(포괄세포학검사이상급고위형HPV지속양성)공176례,수궤분위량조.A조:87례,수선채용궁경Belinson활검겸재음도경지시하행궁경다점활검,연후이용초성조직처리의화BT생물조직투명제제작쾌속석사절편,행병리검사;B조:89례,재음도경지시하행관경다점활검,제작상규석사절편,행병리검사.비교량조적절편질량、제편시간.대A、B조중진단위궁경상피내류변(CIN)Ⅱ급이상병변、특수정황적CIN Ⅰ환자행수술치료,수술방식포괄궁경배형전겁절제술(LEEP)、관경냉도추절술(CKC)、자궁절제술혹궁경암근치술,수술표본술후진행상규병리검사,당활검조직(포괄쾌속혹상규)병리검사화술후표본상규병리검사결과 불부시,이량자중진단결과 교중자위최종진단,비교A、B조적활검조직병리검사결과 여최종진단적부합솔.결과 A、B조절편질량균위만의혹기본만의,능구만족진단요구,절편합격솔균위100%.A、B조적제편시간평균분별위40 min화1 d,량조비교,차이유통계학의의(P<0.05).A、B조중행수술치료적환자분별위30、32례,기활검조직병리검사결과 여최종진단적부합솔분별위93%(28/30)화9l%(29/32),량조비교,차이무통계학의의(P>0.05).결론 활검조직쾌속석사절편병리검사진단궁경병변준학가고、쾌속경제,유추엄사용개치.
Objective To evaluate the application of pathological diagnosis by rapid paraffin sections in the diagnosis and treatment of cervical diseases. Methods A total of 176 cases from our hospital between September 2009 and January 2010 with abnormal cervical cancer screening (including abnormal cytology result and high-risk HPV continuous positive) were randomly divided into 2 groups. Eighty-seven cases of them whose biopsy were got by Belinson forceps under the direction of colposcopy with rapid paraffin sections by ultrasonic histopathological rapid processor and BT transparent agents were selected as group A, while 89 cases with conventional paraffin sections were selected as group B. The production time and quality for paraffin sections were analyzed in the two groups. Those diagnosed as cervical intraepithelial neoplasia (CIN)Ⅱ or even worse and some special patients with CIN Ⅰ in the two groups received surgery, including loop electrosurgical procedure (LEEP) ,cold knife conization (CKC),.hysterectomy or radical hysterectomy.Tissue obtained after surgery was sent for routine pathological examination. If the results of postoperative routine pathological examination were inconsistent with the rapid or routine biopsy pathological examination,the heavier results were regard as the final diagnoses. The pathological results and diagnose accordance rates were recorded and compared between group A and group B. Results The quality of sections in two groups were all satisfied or basically satisfied to meet the diagnostic requirements. There were statistically significant difference in average production time between group A and B (40 minutes vs 24 hours, P < 0. 05). Thirty patients in group A and 32 patients in group B received surgery. The coincidence rate of biopsy pathological results and final diagnoses were 93% (28/30) for group A and 91% (29/32) for group B, in which there were not statistically significant difference (P > 0. 05). Conclusion Bapid paraffin sections technology is safe, accurate and economical for rapid pathological diagnosis of cervical diseases, which is worthy for being widely used in hospitals.