宫颈膜式液基超薄细胞学检测与组织病理学检查的对照研究

A comparison between ThinPtep cytology test and pathology histology

目的研究宫颈检查结果与阴道镜活检病理及宫颈锥形切除病理检查间的相关性。方法采用膜式液基超薄细胞学检测系统（TCT）收集宫颈细胞总计326人次，行阴道镜检查及活检和（或）宫颈锥形切除。描述上述检查结果和病理检查结果之间的关系。结果326人次的检测中，病理证实为宫颈上皮内瘤变（CIN）Ⅱ～Ⅲ的患者共计70人。病理证实为CINⅢ／原发癌（CIS）的患者共计56人。不同的异常细胞学结果提示CINⅢ／CIS的风险系数（RR）分别为：宫颈不典型鳞状上皮（ASCUS）14．7（95％可信区间8．0～27．0，P=0．00）；CINⅠ13．9（95％可信区间6．3～30．9，P=0．00）；CINⅡ44．2（95％可信区间15．5～126．5，P=0．00）；CINⅢ272．2（95％可信区间161．6～458．6，P=0．00）。结论阴道镜检查及活检可以较好地检出TCT异常病例中的CINⅡ～Ⅲ及CINⅢ／CIS组织学类型，其病理结果与宫颈锥形切除病理结果符合。

Objective To study the relativity of abnormal cervical pathology results in cytology and histology.Methods With retrospective analysis of 326 cases of fluid-based thin-layer method（ThinPtep cytology test, TCT）, which reported in the bethesda system, we checked the abnormal results and advised different diagnose biopsy of vaginoscopy and/or conization and got the relativity description of abnormal results in TCT and CIN Ill/CIS, results validated by vaginoscopy match analysis of the CINⅡ-Ⅲ and CIN Ⅲ/CIS results validated by vaginoscopy and conization labeled by the age group and relativity analysis of abnormal results in TCT and CIN Ⅲ/CIS Jesuits validated by vaginoscopy. Results 326 cases had confimed biopsy results validated by vaginoscopy, of which 70 cases were of CIN 56 cases were of CINⅢ/CIS,the risk ratio（RR） of different abnonmal TCT results in predicting CINⅢ/CIS resuils validated by vaginoscopy is ASCUS group 14.7 （95 % confidence interval 8.0- 27.0, P = 0.00 ） ; CINⅠ group 13.9（6.3-30.9,P=0.00）;CINⅡ group 44.2（15.5-126.5,P=0.00）;CINⅢ group 272.2 （161.6-458.6, P = 0.00 ）. Conclusion Vaginoscopy examination and biopsy could verify histology abnormity of CIN Ⅱ- CINⅢ and CINⅢ/CIS from abnormal results of TCT and has a good accordance along with biopsy results of conization.