液基超薄细胞技术用于宫颈病变预防与筛查价值的研究

Value of Liquid-based Cytology Test on Prevention and Screening of Cervical Lesions

目的探讨液基超薄细胞技术用于宫颈病变预防与筛查方面具有的临床诊断价值和社会价值。方法随机选取深圳博爱医院及北京四季康医院2007年06月至2008年07月妇科门诊就诊的10 126例患者,利用液基超薄细胞检测系统(TCT),根据《子宫颈细胞学Bethesda报告系统》(TBS)判断标准,做出诊断。将诊断意义不明确的不典型鳞状细胞(ASCUS)以上病变均列为阳性病例,且在阴道镜下行活检,将细胞学检测结果与活检结果作对比分析。结果10 126例标本中,发现异常涂片622例,其中不典型鳞状细胞(ASC-US)264例;低度鳞状上皮内病变(LSIL)257例:高度鳞状上皮内病变(HSIL)69例,7例鳞状细胞癌(SCC);1 598例为HPV感染;滴虫感染165例;霉菌感染541例;细菌感染209例;有炎性反应性细胞改变的8 419例。宫颈病变与年龄段有一定的关系。细胞学与组织病理检查符合率分别为LSIL 78.99%,HSIL95.65%,SCC 100%。因就诊目的不同而分组,其筛查阳性率组间比较差异无统计学意义(P>0.05)。结论利用TCT技术结合TBS进行宫颈疾病普查,对于预防宫颈癌,筛查早期病变,进行早期治疗提供了很好的诊断依据,具有很高的临床诊断价值及社会价值。

Objective To study the clinical and diagnostic value and social value of liquid-based cytology test on pre- vention and screening of cervical lesions.Methods A total of lO 126 patients were randomly selected for liquid - based cytology test (TCT) from June 2007 to July 2008 in two hospitals of Shenzhen and Beijing.Cervical lesions were diagnosed by TCT according to the standards of the Bethesda system (TBS).The samples with atypical squamous cells of undetermined signifi- cance (ASCUS) and more abnormal cells were defined as positive,then the positive results were compared with those by colpo- scopic biopsy examination.Results There were 622 abnormal cases among 10 126 samples,including 264 cases of ASCUS, 257 cases of LSIL,69 cases of HSIL,7 cases of SCC.There were 1 598 cases of HPV infection,165 cases of trichomonal infec- tion,541 cases of vulvovaginal infection,209 cases of BV infection,and 8 419 eases of reactive cellular changes associated with inflammation.Statistical relationship was found between cervical lesions and ages.Compared with pathologic determination, the diagnostic accordance rate by TCT was 78.99% for LSIL,95.65% for HSIL,and 100% for SCC,respectively.There was no statistical significance in the positive rate among the three groups which was divided by visit purpose (P>0.05).Conclu- sion TCT combined with TBS could be used in early prevention and screening of cervical lesions which would have great clinical diagnostic value and social value.