应用巴氏涂片检查与液基细胞学筛查宫颈癌的对比研究

COMPARATIVE STUDY ON PAP SMEAR AND LIQUID-BASED CYTOLOGY IN CERVICAL CANCER SCREENING IN PHYSICAL EXAMINATION

目的探讨巴氏涂片检查与液基细胞学在普通人群宫颈癌筛查中的价值。方法对2008年7月～2009年12月期间在我院体检的已婚女性进行巴氏涂片检查4638例和液基细胞学检查4250例,细胞学诊断采用TBS(2001)分级报告系统,对细胞学检查结果异常者,进行阴道镜检查,并在阴道镜指导下行宫颈活检,送病理学诊断。结果 4638例巴氏涂片检查中异常者309例,阳性率为6.66%,其中意义不明的不典型鳞状细胞(ASCUS)155例,鳞状上皮内低度病变(LSIL)124例,鳞状上皮内高度病变(HSIL)29例,鳞癌(SCC)1例。经组织活检病理学诊断阳性符合率为87.06%;4250例液基细胞学检查中异常者617例,阳性率为14.52%,其中ASCUS392例,LSIL162例,HSIL58例,SCC3例。经组织活检病理学诊断阳性符合率为92.22%。结论相对巴氏涂片,宫颈液基细胞学可明显提高宫颈疾病的检出率,值得在体检中向已婚妇女人群推广。

ObjectiveTo explore the value of Pap smear and liquid-based cytology in cervical cancer screening of the general population.Methods Right from July 2008 to December 2009 in our hospital during the examination of married women,Pap smears 4 638 cases and 4 250 cases of liquid-based cytology had been made,cytology diagnosis using TBS （2001） classification reporting system; for abnormal cytology test results conducted colposcopy and cervical biopsy colposcopy guided down,send pathological diagnosis.Results Among 4 638 cases the abnormal Pap smears were 309 cases,the positive rate was 6.66%,in which of undetermined significance,atypical squamous cells （ASCUS） 155 cases,of low-grade squamous intraepithelial lesions （LSIL） 124 cases,of squamous cell of highly lesions （HSIL） 29 cases,of squamous cell carcinoma （SCC） 1 case.The pathological diagnosis of biopsy-positive rate is 87.06%.Among 4 250 cases of liquid-based cytology 617 cases are abnormal; the positive rate was 14.52%,including ASCUS 392 cases,LSIL 162 cases,HSIL58 cases,SCC 3 cases.The pathological diagnosis of biopsy-positive rate is 92.22%.Conclusion Compare with Pap smear,cervical liquid-based cytology can significantly improve the detection rate; it is worthy to apply in physical examination for married female population.