57372例液基宫颈脱落细胞学报告分析

Analysis of 57372 cases on cervical liquid cytology

目的:评价宫颈液基细胞学检查在宫颈癌筛查中的敏感性和价值,探讨宫颈病变的相关规律。方法:收集广东省妇幼保健院及广东省48个市县妇幼保健院门诊、住院患者送本院检测的宫颈液基细胞学标本57372例,采用TBS分级系统,意义不明确的非典型鳞状上皮细胞(ASC-US)以上病变为阳性病例,对其中细胞学结果阳性或阴性,但临床怀疑宫颈病变共计4214例,进一步行阴道镜及镜下取活检作组织病理学对照观察,对诊断结果进行比较分析。结果:57372例标本中,49052例(85.50%)未见上皮内病变或恶性病变(NILM),3870例(6.75%)非典型鳞状上皮细胞(ASC)、3862例(6.73%)低级别鳞状上皮内病变(LSIL)、470例(0.82%)高级别鳞状上皮内病变(HSIL)、32例(0.06%)鳞状细胞癌(SCC)、非典型腺上皮细胞(AGC)72例(0.13%)和腺癌(AC)14例(0.02%)。与病理组织学对照的4124例中,细胞学检出100.00%(46/46)鳞状细胞癌(SCC);100.00%(12/12)腺癌(AC);94.42%(372/394)高级别鳞状上皮内病变(HSIL);80.99%(1806/2230)低级别鳞状上皮内病变(LSIL)。CINⅠ、CINⅡ、CINⅢ、鳞癌和腺癌平均年龄分别是(33.30±13.28)岁、(35.30±7.83)岁、(72.25±7.61)岁、(45.61±6.73)岁和(42.67±10.13)岁。结论:宫颈病变,尤其是宫颈癌前病变的发病有年轻化趋势。液基细胞学能更有效地检出宫颈各类病变,结合阴道镜检查,更有助于预防宫颈癌的发病和降低宫颈癌的死亡率。

Objective ： To evaluate the sensitivity and clinical value of liquid - based cytology in the screening of cervical cancer, investigate the relative factors of cervical disease. Methods ： 57 372 cases of liquid - based cytology were collected and observed, when atypical squamous cell of undetermined significance （ ASC - US） or above of the cases were diagnosed by cytology, they underwent biopsy of colposeopy and compared with the biopsy diagnosis. Results： Among the 57 372 cases, 49 052 cases （85.5%） were negative for intraepithelial lesion or malignancy （NILM）, 3 848 cases （6. 71% ） were ASC, 3 862 caes （6. 73% ） were low -grade intraepithelial lesion （LSIL）, 470 cases （0. 82% ） were high- grade intraepithelial lesion （HSIL） , 46 cases （0. 09% ）＇were squamous cell carcinoma （SCC） , 72 eases （0. 13% ） were atypical glandular cell of undetermined significance （AGC）, 6 cases （0. 02% ） were adenoearcinoma （AC） . Compared with the biopsy, the cytology was able to detect 100% （46/46） of SCC, 100% （6/6） of AC, 94. 42% （186/197） of HSIL and 80. 99% （903/1 115） ofLSIL. The average ages ofCIN Ⅰ , CIN Ⅱ, CIN Ⅲ, scc andAC were （33.30±13.28）, （35.30 ±7. 83）, （72. 25± 7. 61 ） , （45. 61 ±6. 73） and （42. 67± 10. 13） years. Conclusion： The cervical lesion, especially the precancer lesion is a younger tendency in age of occurrence of the disease. Liquid - based cytology can detect cervical lesion effectively, coped with colposeopy test, it can decrease the incidence rate and death rate of the cervical cancer.