LCT在宫颈病变筛查中的临床应用价值

Chincal significance of liquid-based cytology test in the detection of cervical lesions

目的:通过与病理组织学比较,评价薄层液基细胞学(LCT)在宫颈病变诊断中的临床应用价值与不足。方法:选取2006年8月～2008年10月宝山中心医院妇产科行LCT检查的340例患者,在电子阴道镜下取宫颈活组织进行细胞学检查。结果:低度鳞状上皮内病变中与病理学的符合率为12.16%(9/74),高度鳞状上皮内病变的符合率为57.89%(22/38),宫颈癌的符合率为73.33%(11/15)。在66例ASC中,15.15%(10/66)为CINⅡ～Ⅲ级,1.51%(1/66)为宫颈癌;16例AGC中,12.55%(2/16)为CINⅡ～Ⅲ级。宫颈癌发病年龄呈现双峰现象,分别为30～39岁和≥45岁。结论:LCT作为宫颈病变的初筛方法,存在一定的假阳性和假阴性,结合阴道镜下活检,能明显提高诊断的准确率,做到早期发现,早期治疗。

Objective： To evaluate the clinical significance and weakness of liquid-based cytology test （LCT） in the diagnosis of cervical lesions. Methods： From August 2006 to October 2008, 340 patients from Baoshan District Center Hospital were received LCT, and underwent cytological examination with cervical tissues under electronic colposcopy. Results： The coincidence rates of LCT with pathologic histology in LSIL, HSIL and cervical cancer were 12.16% （9/74）, 57.89% （22/38） and 73.33% （11/15） respectively. Among 66 cases with ASC, 15.15% （10/66） was with CIN Ⅱ- Ⅲ, 1.51% （1/66） was with cervical cancer diagnosed pathologically. Among the 16 cases with AGC 12.55% （2/16） was with CIN Ⅱ- Ⅲ. In the cases of cervical cancer, the predilection ages of onset showed double hump, 30-39 years old and ≥ 45 years old. Conclusion： As a preliminary screening method of cervical cancer, LCT may have false positive or negative results. But combined with colposcopy and multiple biopsy, LCT can improve the diagnostic accuracy of cervical lesions and be helpful in the early diagnosis and early treatment.