薄层液基细胞学技术筛查鄂尔多斯地区宫颈病变的研究

Study of Thinprep Liquid Based Cytology Test in the Screening of Cervical Lesions in Erdos Area

目的:了解鄂尔多斯地区宫颈癌的发病情况及流行病学特征,评价薄层液基细胞学检测技术在宫颈病变筛查中的应用价值。方法:对鄂尔多斯地区18 071例妇女进行薄层液基细胞学检测,将诊断意义不明的不典型鳞状上皮细胞(ASCUS)以上病变均列为阳性病例,并进行阴道镜下多点取材活检,以病理学结果为金标准,将细胞学检测结果与活检结果作对比分析。结果:TCT法检查18 071例,细胞阳性病例1 042例(5.77%)。检出癌(CA)2例(占0.01%);高度鳞状上皮内病变(HSIL)61例(占0.34%);低度鳞状上皮内病变(LSIL)221例(占1.22%);不除外高度鳞状上皮内病变的不典型鳞状细胞(ASC-H)142例(占0.79%)。取其中426例与阴道镜下活检结果比较,宫颈癌和癌前病变的病理阳性率和准确率分别是CA(100%,100%);HSIL(98.36%,85.25%);LSIL(57.92%,51.58%);ASC-H(64.79%,47.18%)。结论:TCT技术适用于宫颈病变的大规模筛查,三阶梯诊断能明显提高宫颈病变的检出率。宫颈癌及癌前病变发病年龄呈年轻化趋势。鄂尔多斯地区蒙古族妇女宫颈癌及癌前病变检出率高于汉族妇女。

Objective：Through investigating the Cancer of the cervix（CACX） incidence and epidemiologic feature of Erdos area in china,assess the value of thinprep liquid based cytology test（TCT）in diagnosis of cervical lesions.Methods：From Erdos area 18 071 cases of cervical lesions were detected and diagnosed with TCT.The samples of atypical squamous cells（ASC）and more severe than ASC lesions were classified into positive cases,then multi-cervix tissues were biopsied by colposcope.Compared with pathological examination results of cervical biopsies.Results：The postive rate of abnormal epithelial cells diagnosed by TCT was 5.77%.There were 2 cases（0.01%）of CA,61 cases（0.34%）of HSIL,221 cases（1.22%）0f LSIL,142 cases（0.79%）of ASC-H.426 cases with postive cytologic results received pathological examination,The pathological positive rates of CA,HSIL,LSIL and ASC-H were 100%,98.36%,57.92% and 64.79%,respectively.The coincident rate of two examination methods was 100% for CA,85.25% for HSIL,51.58% for LSIL and 47.18% for ASC-H.Conclusion：TCT applies to large scale screening of cervical lesions,three steps diagnosis can obviously elevate the detection rate of cervical lesions.The age of onset tends to get younger in cervical cancer and precancerous lesions.The morbidity rate of the cervical lesions and precancerous lesions among Mongolia woman are higher than that of Han woman.