李欣欣

【摘要】 目的：探討经阴道实时超声弹性成像在宫颈癌前病变与宫颈癌鉴别诊断中的价值。方法：选取2016年5月-2017年5月本院收治的宫颈癌患者50例、宫颈癌前病变患者50例分别设为研究组和试验组，另选宫颈正常查体者50例为对照组。三组均经阴道实时超声弹性成像检查，分析检查结果。结果：研究组超声弹性成像评分均高于试验组、对照组（P<0.05）；研究组超声弹性成像评分为3、4、5分比例明显高于试验组、对照组，比较差异均有统计学意义（P<0.05）；将超声弹性成像评分≥3分作为截断值时，诊断正确率、敏感性及特异性分别为92.0%、94.0%、91.0%；超声弹性成像诊断宫颈癌病灶长径、横径、前后径长度与病理结果比较差异均无统计学意义（P>0.05）；研究组弹性应变率比值为（2.73±1.28），明显高于试验组的（0.81±0.14），比较差异有统计学意义（P<0.05）。结论：经阴道实时超声弹性成像能够有效鉴别诊断宫颈癌前病变与宫颈癌，且可较为准确判断宫颈癌病灶大小，具有较高临床应用价值。

【关键词】 经阴道实时超声弹性成像； 宫颈癌前病变； 宫颈癌； 鉴别诊断

Value of Transvaginal Real-time Ultrasound Elastography in the Differential Diagnosis of Cervical Precancerous Lesions and Cervical Cancer/LI Xinxin.//Medical Innovation of China，2018，15（16）：0-061

【Abstract】 Objective：To investigate transvaginal real-time elastography in the differential diagnosis of cervical precancerous lesions and cervical cancer.Method：A total of 50 cases of cervical cancer and 50 cases of cervical precancerous lesions admitted in our hospital from May 2016 to May 2017 were selected as study group and experimental group respectively，and 50 cases of normal cervix were selected as control group.They were examined by transvaginal real-time ultrasound elastography，and the results were analyzed.Result：The scores of ultrasound elastography in study group were higher than those of experimental group and control group（P<0.05）.The proportion of 3， 4 and 5 points of ultrasound elastography in study group were significantly higher than those of experimental group and control group，the differences were statistically significant（P<0.05）.Ultrasound elastography score≥3 points as a cut-off value，the diagnostic accuracy，sensitivity and specificity were 92.0%，94.0%，91.0% respectively.The length，transverse diameter and anteroposterior diameter of cervical cancer lesions diagnosed by transvaginal real-time ultrasound elastography were compared with pathological results，the differences were not statistically significant（P>0.05）.The elastic strain rate ratio of study group was（2.73±1.28），which was significantly higher than （0.81±0.14） of experimental group，the difference was statistically significant（P<0.05）.Conclusion：Transvaginal real-time ultrasound elastography can effectively identify the precancerous lesion and cervical cancer，and can accurately determine the lesion size of cervical cancer，which has high clinical value.

【Key words】 Transvaginal real-time ultrasound elastography； Cervical precancerous lesions； Cervical cancer； Differential diagnosis

First-authors address：Jiamusi Maternal and Child Health-Care Hospital，Jiamusi 154002，China

doi：10.3969/j.issn.1674-4985.2018.16.017

宫颈癌是严重危害妇女健康的恶性肿瘤疾病，其发病率在妇科恶性肿瘤中仅次于乳腺癌[1]。当前临床上普遍认为人乳头瘤病毒感染是引发宫颈癌的重要因素，感染后患者宫颈上皮细胞可出现上皮内瘤样病变（cervical intraepithelial neoplasia，CIN），增加宫颈癌变风险[2]。鳞状上皮细胞癌在宫颈癌中发生率最高，其次为腺癌、腺鳞癌等[3-4]。随着诊断技术的不断发展，宫颈癌前病变与宫颈癌的鉴别诊断效果有很大提升。常规超声是临床诊断和鉴别宫颈癌前病变与宫颈癌的无创技术，但其对鉴别诊断病灶较小的宫颈癌存在明显受限问题[5]。本研究主要探讨经阴道实时超声弹性成像对宫颈癌、宫颈癌前病变的鉴别诊断的可行性，进一步深入分析其评价宫颈癌浸润范围的价值。现报道如下。

1 资料与方法

1.1 一般资料 选取2016年5月-2017年5月本院收治的宫颈癌患者50例、宫颈癌前病变患者50例分别设为研究组和试验组，另选宫颈正常查体者50例为对照组。……