液基薄层细胞学/TBS检测方法、阴道镜及两者联合应用在诊断宫颈癌及其癌前病变中的临床价值

the value of thinprep cytologic test(TCT) with report mode of TBS,colposcopy and combine method in screening the uterine cervix carcinoma(UCC) and cervical intraepithelial neoplasia(CIN)

目的探讨液基薄层细胞学/TBS检测方法、阴道镜及两者联合应用在诊断宫颈癌及其癌前病变中的临床价值。方法抽取272例宫颈病变患者的液基薄层细胞学检查TBS报告、阴道镜检查结果、组织病理学报告进行回顾性总结分析。结果(1)液基薄层细胞学检查/TBS报告结果为不典型鳞状上皮或腺上皮(ASCUS或AGUS)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)、宫颈癌(UCC)的病理学阳性检出率分别为37.6%(38/101)、46.6%(27/58)、81.3%(26/32)、91.7%(11/12)。假阴性率为5.8%(4/69)。(2)阴道镜检查结果为LSIL、HSIL、宫颈癌的病理学阳性检出率分别为48.6%(71/146)、73.1%(19/26)、83.3%(10/12)。假阴性率为6.8%(6/88)。(3)两者联合应用诊断为LSIL、HSIL、浸润癌的病理学阳性检出率分别为35.8%(58/162)、86.5%(32/37)、100%(15/15)。假阴性率为1.7%(1/58)。结论在同一疾病的不同阶段联合诊断价值不尽相同。液基薄层细胞学检查联合阴道镜诊断与单独应用液基薄层细胞学或阴道镜相比,能够提高HSIL和浸润癌的病理学阳性检出率,降低假阴性率,但对于LSIL而言联合诊断并无优势。

Objective To evaluate the value of thinprep cytologic test（TCT） with report mode of TBS, colposcopy and combine method in screening the uterine cervix carcinoma（UCC） and cervical intraepithehal neoplasia（CIN）. Methods we choosed 272 cases selectively and analyzed the reports of thinprep cytologic test（TCT） with mode of TBS, the conclusions of colposeopy and the reports of histopathology retrospectively. Results 1. The pathological detection rates of ASCUS or AGUS, LSIL, HSIL, UCC were 37.6% （38/ 101 ）, 46.6% （27/58）, 81.3 % （26/32）, 91.7% （11/12） respectively by TCT and TBS report mode. The false negative rate was 5. 8% （4/69）. 2. The pathological detection rates of LSIL, HSIL, UCC were 48.6% （71/146）, 88.5% （23/26）, 83.3% （10/12） respectively by colposeopy.The false negative rate was 6.8% （6/88）. 3. The pathological detection rates of LSIL, HSIL, UCC were 35. 8 % （58/162）, 86.5 % （32/37）, 100 % （ 15/15 ） respectively .by combined application of TCT and colposeopy. The false negative rate was 1.7 % （ 1/58）. Conclusion The values of combined screening are different in different stage of cervical diseases. Compared with TCT and colposcopy alone, TCT associated with colposeopy can evaluate positive pathological detection rate in HSIL and UCC and can cut down false negative rate. But there is no superiority in detection of LSIL.