TCT筛查中不能明确诊断的不典型鳞状及腺上皮细胞病理结果分析

The analysis of pathological results in TCT screening reports of the significance of undermining atypical cells

目的评估新柏氏膜式液基超薄细胞学检测(TCT)报告中不能明确诊断的不典型鳞状及腺上皮细胞的意义,为临床确定不典型鳞状和腺上皮细胞的诊断提供依据。方法搜集15188例TCT标本中的131例ASC-US、ASC-H及AGC患者情况,对其中78例有明确病理诊断的标本进行回顾性分析。结果ASC-US患者中有55.9%为CINⅠ级和SPI改变,40.7%为良性反应性改变,3.4%为CINⅡ～Ⅲ级,浸润癌为0;ASC-H中77.8%为女性生殖道浸润癌,11.1%为CINⅠ级和SPI改变,另11.1%为CINⅡ～Ⅲ级;AGC中良性改变占20%,CINⅠ级和SPI改变、宫内膜不规则增生各占30%,CINⅡ～Ⅲ级与癌症各占10%。结论对于TCT筛查中出现的ASC-US、ASC-H及AGC要采取不同的随访及检查手段,以明确最后诊断,防止漏诊或过度治疗。

Objective To evaluate the significance of undermining atypical cells of TCT screening reports, and to give guidance to clinic doctors in order to use various ways to determine their pathologic diagnosis. Methods 131 ASC-US, ASC-H, AGC patients were selected from 15 188 TCT reports, and gave retrospective study in 78 patients of which who have straightforward pathologic diagnosis were given retrospective study. Results Out of 59 ASC-US patients, 55.9% patients are diagnosed of CIN Ⅰ or SPI, 40.7% of them are classified as normal or reactive action;3.4% of them are diagnosed by biopsy of CIN Ⅱ ～ Ⅲ ; None of them are malignant. Out of 9 ASC-H patients, group CINⅠ or SPI and group CIN Ⅱ～Ⅲ only have 1 patient respectively （ 11.1% ）, but most of them are diagnosed of carcinomas （77.8%）. Among 10 AGC patients, 2 patients are benign lesion （20%） ; 3 people are included in group CINⅠ or SPI and group endometrial irregular hyperplasia （30 % ） respectively; group CINⅡ～Ⅲ and group carcinoma has only 1 people respectively （10%）. Conclusion The ASC-US, ASC-H and AGC patients selected from TCT screening need a final diagnosis by various ways.