两种宫颈阴道细胞学染色方法与报告方式的诊断价值比较

Comparison between two cervical/vaginal cytologic methods for diagnosing the early cervical diseases

目的 :比较HE染色巴氏五级法与巴氏染色TBS诊断系统对宫颈病变的检出率及其与组织病理学诊断的符合率。方法 :对我院妇科门诊 2 0 0 1年 1月至 6月的 4 0 0 5例宫颈 /阴道涂片采用HE染色巴氏五级法作出诊断 ,2 0 0 2年 4月至 8月的2 94 7例宫颈 /阴道涂片采用巴氏染色TBS诊断系统作为报告方式 ,异常者送病理活检。结果 :巴氏染色TBS诊断系统的阳性率为 5 .2 9% (15 6 / 2 94 7)显著高于HE染色巴氏五级法 0 .32 % (13/ 4 0 0 5 ) (P <0 .0 5 ) ;与组织病理学诊断的总符合率为 81.2 %(5 6 / 6 9)显著高于HE染色—巴氏分级法 5 4 .5 % (6 / 11) (P <0 .0 5 )。结论 :用巴氏染色、TBS诊断系统筛查宫颈癌涂片可大大提高细胞学诊断的阳性率 ,能提供更多的活检病例 ,有利宫颈癌及癌前病变的防治。

Objective:To compare the positive rate and its coincidence with biopsy of HE staining-Pap's classification and Pap's staining-The Bethesda System(TBS).Methods:HE staining-Pap's classification were used to examine 4005 smears from January to June in 2001, while 2947 smears from April to August in 2002 were screened by Pap's staining-TBS. Meanwhile the abnormal cases were finally diagnosed by histopathology.Results:The positive rate of Pap's staining-TBS (5.29%) were significantly higher than that of traditional Pap's classification(0.32%)( P <0.05).The coincidence with biopsy of Pap'sstaining-TBS (81.2%) was significantly higher than that of traditional Pap's classification(54.5%).Conclusion:Pap's staining-TBS may serve as a useful method for screening high-risk group of carvical carcinoma which can offer higher positive rate and more biopsies.