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薄层液基细胞学检查与阴道镜病理学活检在宫颈癌及癌前病变筛查中的比较 被引量:12

Comparison between ThinPrep cytologic test and colposcope pathological biopsy in screening of cervical cancer and premalignant lesion
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摘要 目的比较薄层液基细胞学检查(TCT)与阴道镜病理学活检在宫颈癌及癌前病变筛查中的应用价值。方法选取242例TCT结果异常的女性患者为研究对象,进行阴道镜病理学活检,分析TCT与阴道镜病理学活检的诊断符合情况并比较宫颈不同部位阴道镜病理学活检的结果。结果TCT无明确意义的不典型鳞状上皮中宫颈上皮内瘤变(CIN)比例为56.52%(52/92),低度鳞状上皮内病变中CIN比例为88.16%(67/76),高度鳞状上皮内病变中CIN比例为100.00%(67/67),经Pearson等级相关检验,两种检查结果具有一致性(Pearson列联系数=0.7588,r=328.37,P〈0.05)。病灶中心阴道镜病理学活检阳性率为90.22%(83/92),病灶边缘为73.17%(60/82),3、6、9、12点为71.74%(66/92),经单向有序分类资料秩和检验(Kruskal—Wallis法),三个部位阴道镜病理学活检阳性率比较差异有统计学意义(P〈0.05),病灶中心阴道镜病理学活检阳性率高于病灶边缘和3、6、9、12点(P〈0.05),病灶边缘阴道镜病理学活检阳性率与3、6、9、12点比较差异无统计学意义(P〉0.05)。结论TCT结果与阴道镜病理学活检结果具有一致性,对于进行阴道镜病理学活检的患者,在宫颈病灶中心取材的阳性率较高,高于病灶边缘和3、6,9、12点取材。 Objective To study the application values of ThinPrep cytologic test (TCT) and colposcope pathological biopsy in screening of cervical cancer and premalignant lesion. Methods Two hundred and forty-two female patients with TCT results abnormal were selected as the research object, and they were examined in colposcope pathological biopsy. The diagnostic accordance between TCT and colposcope pathological biopsy was analyzed,and the result of colposcope pathological biopsy in cervical different parts was compared. Results In TCT,the ratio of cervical intra-epithelial neoplasia (CIN) in atypical squamous cell of undetermined significance was 56.52% (52/92),that in low-grade squamous intraepithelial lesion was 88.16% (67/76) and in high-grade squamous intraepithelial lesion was 100.00% (67/67),the test results of two methods had consistency by the Pearson rank correlation test (Pearson contingency coefficient = 0.7588, x2 = 328.37, P 〈 0.05). In colposcope pathological biopsy, the positive rate of lesions center was 90.22% ( 83/92 ), that of lesions edge was 73.17% (60/82) and that of 3,6,9,12 point was 71.74% (66/92), there were significant differences among the positive rate of the three parts by the unidirectional ordered categorical data rank and inspection (Kruskal - Wallis method) (P 〈 0.05),the positive rate of lesions center was higher than that of lesions edge and 3,6,9,12 point (P 〈 0.05 ), there was no significant difference in positive rate between lesions edge and with 3,6,9,12 point (P 〉0.05). Conchmion The result of TCT and colposcope pathological biopsy is consistent,and the positive rate of lesions center of colposcope pathological biopsy is higher,which is higher than that of lesions edge and 3,6,9,12 point.
出处 《中国医师进修杂志》 2013年第9期30-33,共4页 Chinese Journal of Postgraduates of Medicine
关键词 宫颈肿瘤 阴道镜检查 癌前状态 细胞学 病理学 Uterine cervical neoplasms Colposcopy Precancerous conditions Cytology Pathology
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