宫颈Thinprep液基细胞学检测结果的临床细胞学分析

The clinicocytologic analysis of results of Thinprep liquid based cytology test in the detection of cervical disease

目的:应用Thinprep液基细胞学技术(TCT)及TBS诊断系统,探讨宫颈癌及癌前病变的相关因素及临床细胞学特点。方法:对11000例受检者的宫颈细胞采用TCT检测和TBS分类诊断,将ASC-US以上病变列为细胞阳性病例,并分析不同宫颈病变与临床的关系。结果:11000例患者TCT标本满意10600例,满意率为96.36%,宫颈细胞学正常者仅77例(0.70%),重度炎性病变2083例(18.94%);细菌性阴道病792例(7.20%),平均年龄32.86±9.59岁;HPV感染444例(4.04%),平均年龄33.06±17.39岁;细胞学阳性病例1206例,阳性检出率10.96%。其中LSIL449例(4.08%),平均年龄34.12±9.84岁,合并HPV感染319例(占71.05%,319/449);HSIL89例(0.81%),平均年龄37.97±9.67岁;CA15例(0.14%),平均年龄47.00±12.66岁;ASC-H73例(0.66%);ASC-US+AGUS共580例(5.27%)。在1206例TCT阳性病例中:宫颈光滑-轻度糜烂组与中-重度糜烂组分别占51.74%、48.26%;正常或轻度炎症组占40.05%,中度炎症组占27.53%,重度炎症组占32.42%。结论:TCT和TBS系统能全面准确地反映宫颈病变情况,宫颈细胞学正常人群比例显著下降;宫颈糜烂程度与宫颈病变阳性检出率无明显相关;HPV感染的发病率日益增高,且是宫颈CIN的重要相关因素。防止HPV感染、高效筛查和密切监测HPV感染对象、及时治疗及阻止CIN病变升级是防止宫颈癌和癌前病变的关键。

Objective： To investigate the relative factors and clinicocytologic features of cervial cancer and precancer lesion with TCT and the Besthesda system （TBS） . Methods： 11 000 cases were detected with TCT and TBS. The samples of atypical squamous cells and more abnormal cell were postive , then analyze the clinic relatives to different cervical lesion. Results： The satisfactory rate of TCT sampies was 96. 36%. Of the 11 000 cases detected by TCT, only 77 cases （0. 70% ） were diagnosed normal; 2 083 cases （18. 94% ） severe inflammation; 792 cases （7. 20% ） bacterical vaginosis （mean 32. 86 ± 9. 59 years） ; 444 cases （4. 04% ） HPV infection （mean 33. 06 ± 17. 39 years） ; the postive rate of TCT cytology was 10. 96% （ 1 206/11 000）.. Of 1206 postive cases , 449 cases were diagnosed LISL （4. 08%, 449/11 000, mean 34. 12 ±9. 84 years） ; 89 eases HSIL （0. 81%, 89/11 000, mean 37. 97 ±9. 67 years） ; 15 cases CA （0. 14%, 15/11 000. mean 47. 00 ± 12. 66 years） ; 73 cases ASC- H （0. 66%, 73/11 000） ; 580 cases ASC-US and AGUS （5. 27%, 580/11 000 , mean 33. 91 ± 11. 89 years） ; the ratio of smooth - slight erosion group is 51. 74% （624/1 206） and the mild -severe erosion is 48. 26% （582/1 206） ; the normal or slight inflammation is 40. 05% （483/1 206） ; and the severe inflammation is 32. 42% （391/1 206） ; the moderate inflammation is 27. 53% （332/1 206） . Conclusion： TCT and TBS can accurately and all - sidely point out cervical lesion, the proportion of normal cervical cells remarkably descend , the extent of cervical erosion is not obvious relative to the positive rate of cervical lesion, the incidence of HPV infection is gradually rising, which is an important correlative factor of CIN. Preventing to be infected by HPV, efficiently screening and surveying HPV infector . curing and blocking the evolving of CIN is the key to prevent cervical cancer and precancer lesion.