新柏氏液基细胞学检查在诊断宫颈病变中的应用

Application of TCT in the diagnosis of cervical lesions

目的 评价新柏氏液基细胞学检查配合阴道镜检查对子宫颈病变的诊断价值及其临床意义。方法 回顾性分析本院妇科门诊2005年2月至2005年9月间行新柏氏液基细胞学检查配合阴道镜检查对子宫颈病变进行筛查，以组织学诊断为金标准，对结果进行分析。结果 液基细胞学检查1473例，发现异常细胞478例（32．45％）。行阴道镜检查＋活检后病理结果显示：子宫颈鳞癌6例，宫颈上皮内瘤样病变（CIN）61例，其中CINⅠ21例，CINⅡ/CINⅢ49例，急慢性宫颈炎（含HPV感染）402例。新柏氏液基细胞学检查诊断宫颈癌和癌前病变的病理阳性率和准确率分别是CA（100％，100％），HSIL（95．0％，85．0％），LSIL（64．7％，35．3％），ASCUS/AGCUS的病理阳性率为10．53％，HPV感染的病理阳性率为6．56％。结论 用液基细胞学检查配合阴道镜下病理检查能及早发现癌前病变。

Objective To evaluate the clinical significance of TCT combined with colposcopy in the diagnosis of cervical lesions. Methods Data of out patients received survey of cervical diseases with TCT combined with colposcopy in our hospital from Feb to Sep this year were documented and retrospectively analyzed. Pathological diagnosis was golden standard. Results Among 1473 cases of TCT, there were 478 cases of abnormal cells （32.45%）. Results of biopsy guided by colposcopy showed： 6 cases of squamous cell carcinoma; 61 cases of CIN, among which were 21 cases of CIN Ⅰ, 49 cases of CIN Ⅱ/CIN Ⅲ; and 402 cases of acute or chronic cervical inflammation （including HPV infection）. Sensitivity and accuracy of TCT in the diagnosis of cervical cancer and pre-cancer lesions were CA （100%, 100%）, HSIL （95.0%, 85.0%）, and LSIL （64.7%, 35.3%）, respectively. Positive rate of pathological diagnosis were 10.53% in ASCUS/AGCUS and 6.56% in I-IPV infection. Conclusion TCT combined with colposcopy guided biopsy could detect early pre-cancer lesions.