Роль кольпоскопии в выявлении предраковых поражений шейки матки у женщин репродуктивного возраста в Казахстане
Ключевые слова:
предраковые поражения шейки матки, кольпоскопия, вирус папилломы человека, биопсия шейки матки, рак шейки маткиАннотация
Введение. Целью данного исследования было изучить распределения генотипов вируса паппиломы человека (ВПЧ) высокого риска при предраковых патологиях шейки матки среди женщин Казахстане и определение степени соответствия результатов кольпоскопии и биопсии шейки матки.
Методы. Это поперечное когортное исследование, проведенное в многопрофильной больнице в Астане, Казахстан, с ноября 2024 года по март 2026 года. Женщины репродуктивного возраста 18–45 лет прошли тестирование на ВПЧ, видеокольпоскопию и биопсию шейки матки под контролем кольпоскопии.
Результаты. В исследование были включены 483 участницы, ранее не вакцинированные против ВПЧ. Кольпоскопия была проведена 285 женщинам. У 48,5% участниц кольпоскопическое заключение было нормальным, у 40,1% – аномальным I степени, и у 10,6% – аномальным II степени. Среди этих 285 пациенток биопсия была произведена 127 участницам, и распределение результатов биопсии значительно различалось между тремя кольпоскопическими заключениями. Процент совпадения между кольпоскопическими заключениями и результатами биопсии составляет 37,5%, невзвешенный коэффициент Каппа Коэна = 0,083 (bootstrap CI - 0.097-0.269), что указывает на слабое совпадение, и квадратично-взвешенный коэффициент Каппа = 0,342 (bootstrap CI [0.178, 0.477]), что указывает на умеренную степень совпадения.
Заключение. Хотя между кольпоскопией и патологией шейки матки наблюдалось расхождение, наши результаты показали, что кольпоскопия потенциально может повысить диагностическую ценность при выявлении изменений шейки матки высокой степени.
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