目的 在阴道镜检查中采用宫颈管搔刮术（ECC）对宫颈癌患者进行预测,研究ECC预测的准确性与诊断效能。方法 选取2020年1月—2023年10月间因宫颈癌筛查结果异常行阴道镜检查及宫颈活检同时行ECC的631例受检者作为研究对象,分析其组织病理学和ECC诊断结果。结果 631例受检者中病理诊断为宫颈癌22例,宫颈腺癌4例,宫颈上皮内低度病变66例、高度病变59例;以病理诊断结果为金标准,ECC对宫颈癌诊断的准确率为97.78%,灵敏度81.82%,特异度98.36%,阳性预测值64.29%,阴性预测值99.34%,Kappa=0.709;ECC对宫颈上皮内病变诊断的准确率为92.23%,灵敏度88.00%,特异度93.33%,阳性预测值77.46%,阴性预测值96.76%,Kappa=0.774。结果提示ECC与病理检查结果有良好的一致性。结论 阴道镜检查中采用ECC在宫颈癌早期筛查中具有较大的应用价值,可以提高早期筛查敏感性,减少漏诊率,从而有助于降低宫颈癌的发病率和死亡率。

Objective To predict cervical cancer patients by endocervical curettage （ECC） during colposcopy, and evaluate the accuracy and diagnostic efficacy of ECC. Methods A total of 631 patients who underwent colposcopy and cervical biopsy with simultaneous ECC due to abnormal results of cervical cancer screening between January 2020 and October 2023 were selected as study subjects, and the histopathological results and ECC results were analyzed. Results According to the histopathological results, 22 cases of cervical cancer, 4 cases of adenocarcinomas, 66 cases of low-degree lesions, and 59 cases of high-degree lesions were detected in the 631 patients. With histopathological results as the gold standard, the accuracy of ECC in cervical cancer screening was 97.78%, the sensitivity was 81.82%, the specificity was 98.36%, the positive predictive value was 64.29%, the negative predictive value was 99.34%, and the Kappa=0.709; the accuracy of ECC in cervical intraepithelial lesion screening was 92.23%, the sensitivity was 88.00%, the specificity was 93.33%, the positive predictive value was 77.46%, the negative predictive value was 96.76%, and the Kappa=0.774. The results suggested good agreement of ECC with pathological examination results. Conclusion The use of ECC in colposcopy has great application value in early screening of cervical cancer patients, and this method can improve the sensitivity of early screening and reduce the rate of missed diagnosis, thereby reduce the morbidity and mortality of cervical cancer.