薄层液基细胞学检测3500例结果及临床分析

Clinical Analysis of Thinprep Liquid Based Cytology Test in 3500 Cases of Cervical Lesions

目的应用薄层液基细胞学技术及TBS诊断系统,探讨宫颈癌及癌前病变的相关因素及临床细胞学特点。方法对3 500例受检者的宫颈脱落细胞采用薄层液基细胞学(TCT)检测和TBS分类诊断,将不典型鳞状上皮细胞(ASCUS)以上病变列为细胞学阳性病例,分析不同宫颈病变及其与临床的关系。结果 3 500例受检者TCT标本满意率为97.36%,细胞学阳性病例447例,总检出率12.77%,其中ASCUS+不典型腺上皮细胞(AGUS)占6.40%;低度鳞状上皮内病变(LSIL)占2.94%;高度鳞状上皮内病变(HSIL)占3.26%;鳞状细胞癌和腺癌(CA)占0.17%;人乳头瘤病毒(HPV)感染348例(9.94%)。在447例TCT阳性病例中,宫颈光滑-轻糜组与中-重糜组分别占50.11%和49.89%。结论 TCT和TBS系统能准确反映宫颈病变情况,HPV是宫颈上皮内瘤样病变(CIN)的重要相关因素,预防HPV感染、筛查和监测HPV感染对象、治疗HPV,及阻止CIN病变是防止宫颈癌的关键。

Objective To study clinical cytological features and relevent factors of cervical carcinoma and precancerous lesions by TCT and The Besthesda System（TBS）.Methods 3 500 cases were examined by TCT and TBS,then the clinical relativity of different cervical lesions was analyzed.Results The satisfactory rate of TCT samples was 97.36%.In the 3 500 cases,the positive rate of TCT cytology was 12.77%（447/3 500） and 348 cases（9.94%） were HPV infected.In the 447 positive cases,6.40% were ASCUS and AGUS,2.94% were LSIL,3.26% were HSIL and 0.17% were CA;the rate of the smooth-slight erosion group and that of the moderate-severe erosion group were 50.11% and 49.89% respectively.Conclusion TCT and TBS might accurately reflect the condition of cervical lesions.Incidence of HPV infection is the important correlative factor of CIN（cervical intraepithelial neop-lasia）.Prevention from the infection of HPV,efficient screening and surveying of HPV infection,curing and blocking the development of CIN are key points for prevention of cervical carcinoma.