Analysis Of The Causes Of Missed Diagnosis Of Cervical Cancer

Objective:to analyze the causes of missed diagnosis of 69 cases of cervical cancer,and to summarize the experience in order to reduce the incidence of missed diagnosis of cervical cancer.Methods:the clinical data of 69 patients with cervical cancer admitted in the second hospital of Jilin University from January 2014 to June 2016 were analyzed retrospectively.the 69 cases of cervical cancer include:7 cases of cervical cancer were found after hysterectomy because of other gynecological diseases;the initial diagnosis was 1 cases of pyometra in patients with cervical cancer;61 cases of cervical cancer patients diagnosed by colposcopy cervical tissue biopsy as HSIL or biopsy pathology slides of cervical tissue by our hospital diagnosed as HSIL.Result:1.69 cases of cervical cancer clinical manifestations: 31.9% contact bleeding,13% abnormal vaginal bleeding,8.7% abnormal leucorrhea,5.8%vaginal discharge,1.4% lumbar pain,but there were 36.2% of no clinical symptoms.2.69 cases of cervical cancer signs: 78.3% cervical erosion,17.4% cervical smooth surface,18.8%cervical hypertrophy,5.85 hysterouxesis,only 2.9% cervical neoplasm.3.45 cases were conducted by TCT,and the results were13.3%NILM,17.8%ASC-US,37.8%ASC-H,4.4%LSIL,24.4% HSIL,2.2%atypical hyperplasia of the glandular epithelium.4.57 cases of cervical cancer were detected by HPV,and the results were93%positiveand7% negative.5.69 cases of cervical cancer were treated by transvaginal ultrasound and the results were 13 cases indicate cervical uneven echo,5 cases showed abundant blood flow signal,4 cases showed abnormal echo in uterine cavity,but there were 47 cases(68.1%)found no positive.6.Cervical biopsy results of.61 cases of cervical cancer were as follows: grade CINIII in 20 cases and gradular CINIII in 41 cases.7.61 cases of cervical biopsy of cervical cancer in HSIL: 39 cases of cervical cold knife conization,conization of paraffin wax pathology are cervical cancer.Among them,29 cases were given frozen pathology.The results were as follows:gradular CINIII in 8 cases of cervical cancer,and the misdiagnosis rate of cervical conization pathological was 27.6%.8.61 cases of cervical biopsy of cervical cancer in HSIL: 19 patients refused the cervical cold knife conization,requiring direct hysterectomy,uterine resection paraffin pathology were cervical cancer Of which 11 cases of hysterectomy specimens were sent for frozen pathology.The results were as follows: 7 cases of grade CINIII,4cases of cervical glandular carcinoma,hysterectomy frozen pathological cervical cancer misdiagnosis rate was 63.6%.9.61 cases of cervical cancer cervical biopsy in HSIL: 3 patients undergoing cervical conization,we saw the cervical canal has cauliflower tissue outflow and carried out cervical curettage,intraoperative frozen pathological examination results were(cervical)invasive squamous cell carcinoma,radical resection of cervical cancer was carried out.It is worth noting that 3 cases of gynecological ultrasound showed different degrees of cervical enlargement.Conclusion:1 the clinical manifestations and signs of patients with cervical cancer are sometimes nonspecific.2 the accuracy of cervical cytology in the diagnosis of cervical cancer is not high.3.HPV negative can also occur in cervical cancer.4.there were ofen no positive findings of ultrasound in early cervical cancer5 cervical biopsy is not sufficient for early invasive cervical carcinoma.6 cervical cold knife conization frozen pathological diagnosis of cervical cancer has some limitations.