液基细胞学和阴道镜在宫颈病变筛查中的应用

Application of thinprep cytologic test and colposcopy to sieve cervical disease

目的评价宫颈液基细胞学(thinprep cytologic test,TCT)涂片配合阴道镜检查对宫颈病变的诊断价值。方法2005年5月至2006年12月我院门诊主诉性交后出血、白带多、检查宫颈糜烂患者648例行宫颈液基细胞学涂片检查,80例液基细胞学涂片异常者均行阴道镜检查,于可疑处行宫颈活体组织病理检查。结果TCT涂片异常率为12.3%(80/648);80例TCT涂片阳性病例中CIN I级及以上诊断与宫颈活体组织病理检查中CIN I级及以上诊断的符合率为86.3%(69/80),灵敏度为78.9%(30/38),特异性为92.9%(39/42),Kappa=0.72;TCT涂片诊断宫颈鳞癌2例均经阴道镜检查和宫颈活体组织病理检查证实。结论TCT涂片配合阴道镜检查能及早发现宫颈病变。

Objective To evaluate the value of thinprep cytologic test （TCT） smear combined with colposcopy for the diagnosis of early cervical disease. Methods A total of 648 outpatients in our hospital with sexual intercourse bleeding, more whites, cervical erosion were detected by TCT and colposcopy. Some dubious cases were diagnosed by colposcopy biopsy. Results Of 648 cases detected by TCT, 80 cases showed abnormal smear results, The abnormal smear rate was 12. 3 %. The consistency rate of TCT and biopsy for CIN I or higher grades diagnosis was 86.3 % （69/80）. The sensitivity was 78. 9 % （30/38） , specificity was 92. 9 % （39/42） , and Kappa = 0. 72. 2 cases of cervical squamous cell carcinoma identified by TCT were all confirmed by colposcopy biopsy. Conclusion TCT combined with the colposcopy biopsy can find cervical disease earlier.