宫颈病变诊断中计算机辅助细胞检测与病理组织学对比分析

Comparison of the effects between papnet cytology computer technology and multiple biopsies in diagnosis of cervical intraepithelial lesion.

目的 通过与病理组织学比较 ,评价宫颈脱落细胞计算机辅助细胞检测 (CCT)在宫颈病变诊断中的准确性及应用价值。方法 首都医科大学附属北京友谊医院对 1997年 12月至 2 0 0 2年 7月行宫颈脱落细胞CCT检查的 1372例患者在电子阴道镜下取宫颈活组织进行病理组织学检查。结果 CCT结果正常为 8 75 %(12 0 / 1372 ) ,不典型鳞状细胞 (ASCUS) 6 0 0 6 % (82 4 / 1372 ) ,低度鳞状上皮内病变 (LSIL) 2 5 2 9% (347/ 1372 ) ,高度鳞状上皮内病变 (HSIL) 5 5 4 % (76 / 1372 ) ,鳞癌及腺癌分别为 0 2 9% (4 / 1372 )和 0 0 7% (1/ 1372 )。经阴道镜下多点活检后的病理组织学检查 ,诊断为炎症者 5 2 4 1% (719/ 1372 ) ,宫颈上皮内瘤变 (CIN)Ⅱ和CINⅢ增加到16 84 % (2 31/ 1372 )。ASCUS患者 10 4 4 %病理组织学结果为CINⅡ ,2 0 6 %为CINⅢ ,0 4 9%为鳞癌。CCT与病理组织学的符合率在LSIL中为 2 8 82 % ,在HSIL中为 5 2 6 3% ,在鳞癌为 75 0 0 %。CCT与病理组织学在人乳头瘤病毒 (HPV)诊断上有较大差异 (P <0 0 1)。结论 CCT与病理组织学有一定的相关性 ,可作为判断宫颈病变程度的参考指标 ,同时CCT有一定的假阴性及假阳性率。

Objective To evaluate the effects of cytology computer technology(CCT) in diagnosis of cer vical intraepithelial lesion by comparison with multiple biopsies. Methods From December 1997 to July 2002,1372 patients with CCT in the Department of Obst etrics and Gynecology,Beijing Friendship Hospital,Capital University of Medical Science received colposcopic examinations and multiple biopsies. Results In the 1372 patients diagnosed by CCT,8.75% (120/1372)were normal,60.06% with ASCUS(824/1372),25.29%(347/1372) with LSIL,5.54%(76/1372) with HS IL,0.29%(4/1372) w ith squamous cell carcinoma and 0.07%(1/1372) with adenocarcinoma.However,after examination by colposcopy and multiple biopsies,the cases with inflammation inc reased to 52.41%(719/1372),CINⅡ and CINⅢ increased to 16.84%( 231/1372).A mong t he 824 cases with ASCUS,10.44% were with CINⅡ,2.06% with CINⅢ,0.49% with squ amous cell carcinoma diagnosed by pathologic histology.The coincidence rate of C CT with pathologic histology was 28.82% with LSIL,52.63% with HSIL and 75.00 % with squamous cell carcinoma.The coi ncidence rate in diagnosing human papillomavirus infection(HPV) was significantl y different between both methods(P<0.01).Conclusion CCT is a cytology screening method for diagnosing cervical intraepithelial lesio n.There are false positive and negative results.