液基细胞学应用于宫颈癌筛查的研究

Study on cervical carcinoma screening with liquid-based cytologic test.

目的 评价AutoCyteprep液基细胞学 (LCT)薄片制片对宫颈癌筛查的准确性。 方法 2 0 0 3年 8～ 12月广东省东莞市人民医院采用LCT制片及传统宫颈细胞涂片法分别对 4 119例、16 92例受检者进行宫颈癌筛查。细胞诊断采用TBS分级系统 ,阳性诊断包括意义不明的不典型鳞状上皮 (ASCUS)以上病变。所有ASCUS以上病变的受检者全部在阴道镜下活检。结果 LCT薄片法和传统涂片法对ASCUS以上病变的检出率分别为10 5 %、5 2 % ,两者结果差异有显著性意义 (P <0 0 1)。LCT薄片法与病理诊断的阳性符合率为 35 5 % ,显著高于传统涂片法 (2 0 5 % ) ,P <0 0 5。结论 LCT薄片检出ASCUS以上病变阳性率比传统涂片法具有明显优势。液基细胞学的TBS诊断法与阴道镜下定位活检、病理检查结合可以显著提高宫颈癌前病变的准确率。

Objective To evaluate the accuracy of liquid-based (LB) technologies (LCT) for screening cervical carcinoma. Methods 4119 cases and 1692 patients in Dongguan People's Hospital,Guangdong Province, from August to December 2003 were screened for cervical carc inoma with LCT and traditional cervical cells smears respectively.Cell diagnosis adopted TBS-group system,and positive diagnosis included above-ASCUS path ological changes.All the examinees of above-ASCUS pathological changes were ex amined with colposcope. Results The above-ASCUS pathological changes identified by LCT and traditional smears we re 10.5% and 5.2% respectively.There was obvious difference between them (P <0.01).The positive coincidence rate between LCT and pathological examinatio n was 35.5%,higher than that of traditional smears(20.5%,P<0.05). Conclusion The LCT methods have apparent dominance in detecting above-ASCUS pathologica l changes than traditional smears.The combining use of LCT,orientational examina tion under colposcope and pathological examination can improve the accuracy of i dentifying cervical lesion.