418例TCT联合阴道镜活检宫颈癌前病变的诊断分析

Effect 418 examples TCT union vaginoscope biopsy cervical cancer pathological change diagnostic analysis

目的：对TCT和阴道镜活检病理结果进行对比分析,并进一步探讨二者在宫颈癌前病变诊断中的价值. 方法：回顾性分析209例阳性宫颈的液基细胞学和对应的阴道镜活检病理检查的结果,进行对比研究.结果：209例阳性TCT病例中,ASCUS 194例（46.41%）、LSIL 112例（26.79%）、HSIL 104例（24.88%）、鳞状细胞癌8例（1.92%）.416例经阴道镜下多点活检,病理诊断如下：炎症94例（22.49%）、CIN Ⅰ级140例（33.49% ）、CIN Ⅱ级64例（15.31% ）、CIN Ⅲ级102例（24.40% ）、浸润癌18例（4.31%）.与病理结果比较,209例TCT报告中,LSIL的诊断符合率58.93%（66/112）,HSIL及以上病变的诊断符合率92.86%（104/112）,LSIL与HSIL及以上搞变的诊断符合率比较,差异有显著性（X2=7.49,P〈0.01）.结论：TCT作为宫颈病变的初筛手段,能够发现大量的宫颈癌前病变患者,结合阴道镜下活组织检查,大大提高了宫颈癌前病变的检出率.

Objective： Carries on the contrast analysis to TCT and the vaginoscope biopsy pathology result,and further discusses the two the pathological change to diagnose in front of cervical cancer the value. Methods： The review analysis 209 example masculine cervix of the uterus fluid basal cell study and the corresponding vaginoscope biopsy pathology inspection result, conduct the contrast research. Results：In 209 example masculine TCT case of illness, ASCUS 194 examples （46.41%）, LSIL 112 examples （26.79%）, HSIL 104 examples （24. 88 %）, squamose cell cancer 8 examples （1.92% ）. 416 examples after the vaginoscope under the multi-spot biopsy, the pathological diagnosis are as follows： Inflammation 94 examples （22.49%） ,CIN ⅠLevel 140 examples （33.49 %） ,CIN ⅡLevel 64 examples （15.31%） ,CIN Ⅲ Level 102 examples （24. 40 %）,infiltration cancer 18 examples （4.31%）. Compares with the pathology result,in 209 example TCT report, LSIL diagnosis coincidence rate 58.93 % （66/112）, HSIL and above pathological change diagnosis coincidence rate 92.86 % （104/112）, LSIL and HSIL and above do the diagnosis coincidence rate which changes to compare, the difference has the significance （Х^2 = 7.49, P〈0. 01）. Conclusion： TCT initially sieves the method as the cervix of the uterus pathological change, can discover in front of the massive cervical cancers the pathological change patient, unifies under the vaginoseope the living tissue inspection, enhanced in front of cervical cancer the patho- logical change to pick out greatly rate.