间隔8个月液基细胞学宫颈病变筛查结果对比分析

An analysis of two screening results of cervical disease by liquid-based cytological diagnosis at an interval of 8 months

目的评价液基细胞学对宫颈病变的诊断价值,讨论宫颈癌筛查方案.方法利用新柏氏TCT液基超薄细胞学,间隔8个月两次进行本院职工宫颈病变筛查715例,对TBS分级系统细胞学阳性者进行阴道镜下活检结果对比.结果间隔8个月两次筛查宫颈细胞学阳性率分别是7.4%(53/715)和4.5%(32/715),两次活检结果CINⅡ以上分别是8例和1例.结论TCT液基超薄细胞学系统能够明显降低宫颈病变筛查的假阴性率,对于细胞学阳性者应在阴道镜下活检明确诊断并积极物理治疗或宫颈电环切除或子宫切除术,然后每年复查一次;对于细胞学阴性者每2～3年筛查一次,即可达预防宫颈浸润癌的发生.

Objective To evaluate the liquid-based cytological diagnosis in cervical disease, and discuss screening method of cervical carcinoma. Methods Two screenings of cervical carcinoma by Thinprep Cytological Test （TCT）, at an interval of 8 months, were conducted among employees of Shenzhen 2^nd Hospital and 715 cases were collected,from which 85 TBS （the Bethesda System） positive cases were compared with colposcopical biopsy result. Results In two screenings at an interval of 8 month,TCT positive ratios were 7.4% （53/715） and 4.5% （32/715）, while cases that biopsy resulted in over CIN Ⅱ were 8 and 1. Conclusion TCT system can significantly reduce false-positive ratio in screening of cervical carcinoma. Patient that is cytological positive should be diagnosed affirmatively by colposcopical biopsy and receive cervical physical treatment, cervical loop excision or hysterectomy, and then with follow-up TCT every year. Patients with negative cytologieal result should take TCT every, 2-3 years, so that invasive cervical carcinoma can be prevented.