液基细胞学检测及TBS分级系统检测宫颈病变3325例临床分析

Evaluation of 3325 cervical smear tests:comparison of thin prep cytology test and TBS classification

目的:评价液基细胞学(thinprep cftologY,test,TCT)检测对宫颈癌筛查的准确性。方法:采用TCT制片及宫颈巴氏涂片,分别对3 325例门诊患者进行宫颈癌筛查,诊断采用TBS分级系统。对所有无明确诊断意义的不典型鳞状上皮(ASCUS)以上患者均做阴道镜检查并活检。结果:TCT和巴氏涂片对低度鳞状上皮内病变(LSIL)以上病变的检出率分别为2.20%、1.28%,两者结果差异有显著性意义(P<0.01)。TCT检出LSIL、高度鳞状上皮内病变(HSIL)、鳞状细胞癌(SCC)与阴道镜下病检阳性的符合率分别是75.00%、88.88%、100%。巴氏涂片检出LSIL、HSIL、SCC与阴道镜下病检的符合率分别是46.43%、50%、50%。两种方法比较差异有显著性意义(P<0.01)。结论:TCT比传统巴氏涂片有较高的敏感性,大大提高了宫颈癌及癌前病变的检出率,用于宫颈癌的筛查,可提供早期发现宫颈癌前病变的信息。

Objectlve：To evaluate the accuracy of thin prep cytology test （TCT） in the screening of cervical carcinoma. Methods： 3325 outpatients receiving cervical cancer screening were tested using TCT and cervical PAP smear tests. Diagnosis was made using the rIBS classification. Those with atypical squamous cells of undetermined significance,（ASCUS） were tested further by eolposeopie examination and biopsy.Results： The rates of detection of LSIL changes or higher by TCT and PAP smear test were 2.2% and 1.28% respectively. This difference was statistcally significant （P〈0.01）.The correlation between TCT and positive eolposcopic result for LSIL,high grade intraepithelial change （HSIL） and squamous cell carcinoma （SCC） were 75%, 89% and 100% respectively. The correlation between PAP smear test result for LSIL,HSIL and SCC were 46.4% ,50% and 50% respectively. The difference between the two tests was statistically signifieant（P〈0.01）.Condusion：TCT is more sensitive than the traditional PAP smear test. TCT results in higher rate of detection of cervical carcinoma as well as its precancerous stage. The use of TCT in cervical carcinoma screening will help to detect signs of early cervical cancer changes.