TCT检查联合宫颈活检结果临床病理分析

Clinicopathologic Analysis of the Union of TCT and Cervical Biopsy Results

目的探讨应用液基薄层细胞学(TCT)检查联合阴道镜下宫颈活检的病理诊断结果对临床宫颈疾病的病因诊治方案提供的价值。方法对3003例受检者的宫颈脱落细胞行膜式液基薄层细胞学(TCT)检查和TBS分类诊断,细胞学阳性者行阴道镜下宫颈多点活检,并行病理组织学检查。结果3003例标本中,76例标本不满意,不满意率2.53%。剩余2927例中无上皮内病变或恶性病变(NILM)伴或不伴炎症者2748例(93.88%);意义不明的非典型鳞状细胞(ASCUS)73例(2.49%);不除外高度鳞状上皮内病变的非典型鳞状细胞(ASC-H)10例(0.34%);低度鳞状上皮内病变(LSIL)75例(2.56%);高度鳞状上皮内病变(HSIL)14例(0.48%);鳞状上皮癌(SCC)6例(0.20%);非特异性的不典型腺细胞(AGC)1例(0.03%)。在微生物检查中:菌群变化,提示细菌性阴道病患者265例,检出率(9.05%);真菌,形态学上符合念珠菌属患者129例,检出率(4.41%);提示疱疹病毒感染者1例,检出率(0.03%);滴虫10例,检出率(0.34%);与病理组织学对照:慢性炎伴挖空细胞或CINⅠ级54例(1.84%);CINⅡ级49例(1.67%);CINⅢ级11例(0.38%);SCC9例(0.31%)。结论TCT技术联合宫颈活检病理组织学结果对临床病因诊治方案提供重要依据,具有重要价值。

Objective To evaluate the pathological diagnosis value provided by the program of the ThinPrep liquid-based cytology test（TCT） combined the results of cervical biopsy through colposcopy examination for clinical diagnosis and treatment.Methods 3 003 cases of cervical exfoliated cells lines were examined by the ThinPrep cytology（TCT） and diagnosed with TBS classification,cervical multi-point biopsy under the colposcopy and histopathological examination were underwent for the positive cases.Results In 3 003 cases of specimens,76 specimens were not satisfied（2.53%）;of the remaining 2 927 cases,2 748 cases（93.88%） were negative for intraepithelial lesion or malignancy（NILM） with or without inflammation,73 cases（2.49%） were atypical squamous cells of undetermined significance（ASCUS）,10 cases（0.34%） were atypical squamous cells of undetermined significance which can not exclude high-grade squamous intraepithelial lesions（ASC-H）,Low-grade squamous intraepithelial lesion（LSIL） were in 75 cases（2.56%）,high-grade squamous intraepithelial lesion（HSIL） were 14 cases（0.48%）,and there were 6 cases（0.20%） of squamous cell carcinoma（SCC）,1 case（0.03%） of non-specific atypical glandular cells（AGC）.While for the microbiological examination,flora,suggesting that patients with bacterial vaginosis were in 265 cases and（9.05%）,Fungi,morphologically consistent with candida were in 129 cases（4.41%）,suggesting that herpes virus infection in 1 case（0.03%）,trichomoniasis in 10 cases（0.34%）.Comparison with histopathology,there were 54 cases（1.84%） of chronic inflammation with hollowing cells or CIN Ⅰ grade,49 cases（1.67%） of CIN Ⅱ grade,11 cases（0.38%） of CIN Ⅲ grade,9 cases（0.31%） of SCC.Conclusion TCT United histopathologic results of cervical biopsy had great value for the clinical etiology diagnosis and treatment programs.