液基细胞薄层涂片技术与巴氏涂片法在宫颈癌中诊断价值的比较分析

Comparison of valuation of thin-layer,liquid-based cytology pap smear test with conventional Papanicolaou smear in screening cervical cancer

[目的]评价液基细胞薄层涂片技术(the thin-layer,liquid-based cytology pap smear test,TCT)及传统巴氏涂片法对早期子宫颈癌及癌前病变的诊断价值,为临床医生提供更准确的依据。[方法]采用早在50年代的巴氏涂片法和90年代的薄层液基细胞检测法对1685例成年妇女进行细胞学检测,报告方式采用2001年的TBS标准,以组织学活检作为阳性对照,进行统计学处理,评价液基细胞薄层涂片技术的诊断价值。[结果]薄层液基细胞学检测法和巴氏涂片法与组织活体检测的符合率分别为:鳞状上皮内低度病变(LSIL)83.12%和68.31%;鳞状上皮内高度病变(HSIL)91.01%和61.67%;鳞状细胞癌(SCC)为100%和75%。[结论]液基细胞薄层涂片技术的敏感性和特异性明显高于传统巴氏涂片检测法,对早期子宫颈癌及癌前病变筛查有重要的价值。

[Objective] To evaluate the diagnostic valuation of the thin-layer,liquid-based cytology pap smear test（TCT） with the conventional Papanicolaou smear in screening early stage cervicalcarcinoma and precancerous lesion in order to provide a right diagnosis to the clinical doctors.[Methods] Adult women（n=1685） were enrolled for the cytological examination by the method of the conventional Papanicolaou smear in 50＇s and the thin-layer,liquid-based cytology pap smear test in 90＇s.The results were reported according to TBS standard bulit in 2001,and histological examination results were used as gold standard to evaluate the diagnostic value of TCT.We controlled the data by statistics.[Results] The accuracy of detection of the thin-layer,liquid-based cytology pap smear test（TCT） and the conventional Papanicolaou smear compared with histological examination was relatively as follows： low grade squamous inner dermal carcinoma lesion（LSIL） 83.12% and 68.31%,high grade squamous inner dermal carcinoma lesion（HSIL） 91.01% and 61.67%,squamous cell carcinoma（SCC） 100% and 75%.[Conclusion] The sensitivity and specificity of TCT are obviously higher than Papanicolaou smear,so this assay is very significant to screening for early stage cervical cancer and precancerous lesion.