液基细胞学联合阴道镜下活检在子宫颈病变诊断中的临床应用

Clinical application of TCT technique combined cervical biopsy by vaginoscopy in diagnosing utero-cervical disease

目的:评价液基细胞学检测技术(简称TCT)及阴道镜下活检在宫颈病变诊断中的作用。方法:对1466例受检者的宫颈细胞采用TCT技术检测,将诊断意义不明的不典型鳞状细胞(ASCUS)以上病变均列为细胞阳性病例,对其中90例行阴道镜下多点取材活检。结果:TCT检查1466例,细胞学阳性127例,占8.66%,其中ASCUS 47例(3.20%)、低度鳞状上皮内病变(LSIL)77例(5.25%)、高度鳞状上皮内病变(HSIL)2例(0.14%)。对细胞学阳性中90例进行阴道镜下活检,与病理组织学对照,ASCUS(C INⅠ-Ⅱ7例、C INⅢ2例、SCC1例);LSIL(C INⅠ-Ⅱ19例、C INⅢ7例、SCC1例);HSIL(SCC1例)。结论:TCT筛查联合阴道镜下活组织病理检查,能早期发现子宫颈病变。

Objective： To assess the value of thinprep liquid based cytology test （TCT） and cervical biopsy by vaginoscopy in diagnosis of cervical lesions. Methods： 1 466 cases were examined with TCT technique, The samples of atypical squamous cells （ASCUS） and more severe than ASCUS lesions were classified into postive cytology, among them, 127 positive cases in the cytologic diagnosis were examined by vaginoscopy and pathologic biopsy. Results： Among all the 1466 cases examined with TCT technique, 127 cases were positive of the cytologic diagnosis （8.66%）. Among them, 90 cases were analyzed with pathologic biopsy by vaginoscopy, and to be divided into the following subsets： 47 cases for atypical squamous cells （ASCUS, 3.20% ） , 77 cases for low grade squamous intraepithelial lesion（ LSIL, 5.25% ） , 2 cases for high grade squamous intraepithelial lesion （HSIL, 0.14% ）. Compared with the result obtained from the pathologic diagnosis, 29 cases for AUCUS （CIN Ⅰ -Ⅱ 7 cases, CINⅢ 2 cases, SCC lcase）; 58 cases for LSIL （CIN Ⅰ -Ⅱ 19cases, CINⅢ 7 cases, SCC 1 case） ; 2 cases for HSIL （SCC 1 case）. Conclusion： TCT technique combined with vaginoscopy and pathologic biopsy can contribute to the early discovery of utero-cervical cancer.