液基薄层细胞学检测在宫颈病变临床筛查中的应用

Application of thinprep cytologic test in the screening of cervical lesions

目的评估液基薄层细胞学(TCT)检测在宫颈病变临床筛查中的价值。方法选择2011年8月至2014年8月在我院就诊经TCT检测异常的宫颈病变患者700例,根据TCT检测结果分为不典型鳞状细胞和腺细胞(ASCUS)、低度及高度鳞状上皮内病变(LSIL/HSIL)、鳞癌或腺癌(SCC/AC),并随后进行了高危型人乳头瘤病毒(HR-HPV)检测和经宫颈活检。将三种方法的检测结果进行对比。结果 700例患者的TCT检测结果为ASCUS 364例(52.0%),LSIL 256例(36.6%),HSIL 72例(10.3%),SCC例8例(1.1%);宫颈活检结果为正常或炎症332例(47.4%),宫颈上皮内瘤变Ⅰ级(CIN I)216例(30.9%),宫颈上皮内瘤变Ⅱ级(CINⅡ)72例(10.3%),宫颈上皮内瘤变Ⅲ级(CINⅢ)72例(10.3%),宫颈癌(CC)8例(1.1%);HR-HPV阳性496例(70.9%),阴性204例(29.1%);HR-HPV阳性率随着TCT检查分级ASCUS、LSIL、HISL的增高而增高(P<0.05)。结论 TCT与人乳头瘤病毒检测、宫颈活检符合率均较高,为宫颈病变重要的临床筛查和诊断方法,能及时发现大量的宫颈病变。

Objective To evaluate the value of thinprep cytologic test （TCT） in the screening of cervical le-sions. Methods Seven hundred patients with cervical lesions showing abnormalities in TCT in our hospital from Oc-tober 2009 to September 2012 were selected. The patients were divided into three classifications according to TCT re-sults：undetermined significance atypical squamous cells and glandular cells （ASCUS）, low-grade squamous intraepi-thelial lesions （LSIL） or high-grade squamous intraepithelial lesions （HSIL）, squamous cell carcinoma （SCC） or ade-nocarcinoma （AC）. The three groups of patients then underwent high-risk human papillomavirus （HR-HPV） testing and transvaginal cervical biopsy. The test results of the three methods were compared. Results TCT results showed 364 cases （52.0%） of ASCUS, 256 cases （36.6%） of LSIL, 72 cases （10.3%） of HSIL, and 8 cases （1.1%） of SCC cas-es. Cervical biopsy results showed 332 cases （47.4%） of normal or inflammation, 216 cases （30.9%） of cervical in-traepithelial neoplasia （CIN）Ⅰ, 72 cases （10.3%） of CINⅡ, 72 cases （10.3%） of CINⅢ, and 8 cases （1.1%） of cervi-cal cancer. According to HR-HPV testing, 496 cases （70.9%） were diagnosed as HR-HPV-positive, and 204 cases （29.1%） were diagnosed as negative. The higher the classification of TCT （ASCUS, LSIL and HISL） was, the higher the HR-HPV positive rate was （P〈0.05）. Conclusion TCT is of a high consistent rate with human papillomavirus testing and cervical biopsy, which could serve as an important clinical diagnostic method for cervical lesions.