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【目的】评价液基薄层细胞学（TCT ）检查，电子阴道镜检查及镜下活检病理在高级别宫颈上皮内瘤变（CIN）的诊断价值。【方法】对本院2009年1月至2013年5月行TCT检查诊断为高度鳞状上皮内瘤变（HSIL）的247例患者，行电子阴道镜检查根据图像做出诊断并行活检送病理检查。对TCT结果与阴道镜活检的病理诊断及阴道镜下诊断与活检的病理诊断进行对比分析。对156例术前阴道镜活检病理与术后石蜡切片病理进行对照研究。【结果】247例 TCT 结果为 HSIL的患者中，宫颈阴道镜下活检病理诊断为高级别CIN即CINⅡ和 CINⅢ为221例（89．5％），浸润癌为5例（2．0％）。电子阴道镜在宫颈疾病诊断中敏感性为98．7％（231/234），阳性预测值95．9％（231/241）；阴道镜拟诊与活检病理学诊断的关系两组比较差异无统计学意义（P ＞0．05）。阴道镜活检病理与术后石蜡切片病理的比较差异有统计学意义（P ＜0．05）。【结论】TCT是筛查高级别CIN的有效方法；电子阴道镜是辅助诊断高级别CIN的可靠而重要的手段，典型的异常阴道镜图像是诊断高级别CIN和宫颈癌的重要手段；单独阴道镜下活检病理诊断不能替代术后诊断。“,”[Objective] To evaluate the value of thinprep cytologic test (TCT ) ,electronic colposcopy and colposcopically directed biopsy pathology in the diagnosis of high - level cervical intraepithelial neoplasia (CIN) .[Methods]A total of 247 patients with high squamous intraepithelial neoplasia(HSIL) diagnosed by TCT in our hospital from Jan .2009 to May 2013 received electronic colposcopy ,and were diagnosed by ima-ges .Cervical biopsies were performed for pathological examination .The results of TCT were compared with the results from electronic coloposcopy and colposcopically directed biopsy pathology .The pathology of 156 cases by colposcopy was compared with the pathology by paraffin section .[Results]Among 247 cases of HSIL by TCT ,221 cases(89 .5% ) were high -level CIN (CINⅡ and CINⅢ ) diagnosed by colposcopically directed biopsy pathology ,and 5 cases(2 .0% ) were infiltrating carcinoma .The sensitivity and positive predictive value of electronic colposcopy for the diagnosis of cervical disease were 98 .7% (231/234) and 95 .9% (231/241) ,re-spectively .There was no significant difference between colposcopy inspection and colposcopically directed bi-opsy pathology( P>0 .05) .There was significant difference between colposcopically directed biopsy pathology and postoperative paraffin section pathology ( P<0 .05) .[Conclusion] TCT is an effective method for screen-ing high-level CIN .Electronic colposcope is an important and reliable clinical examination method for the auxiliary diagnosis of high -level CIN .Typical abnormal cervical images under colposcopy have a critical diag-nostic value in high -level CIN and cervical cancer .Single colposcopically directed biopsy pathology can not take place of postoperative pathological diagnosis .