液基细胞学与阴道镜在宫颈病变诊断中的联合应用

Combined application of liquid-based cytology and colposcopy in diagnosis of cervical lesions

目的:探讨液基细胞学检测(TCT)和电子阴道镜在子宫颈病变筛查中的诊断价值。方法:采用TCT对宫颈涂片进行宫颈病变筛查,对其中细胞学筛查为异常结果的进行阴道镜检查及镜下活组织病理检查。结果:TCT检查2066例中,细胞学阳性112例,占5.42%。其中意义不明确的不典型鳞状上皮细胞(ASCUS)61例(2.95%),低度鳞状上皮内病变(LSIL)36例(1.74%),高度鳞状上皮内病变(HSIL)15例(0.73%);阴道镜检查及镜下活组织病理检查发现异常阴道镜图像88例(78.57%)。与病理组织学对照,ASCUS(CINⅠ32例、CINⅡ8例、CINⅢ2例);LSIL(CINⅠ23例、CINⅡ7例、CINⅢ2例、SCC1例);HSIL(CINⅡ5例、CINⅢ7例、SCC1例)。结论:TCT技术辅助阴道镜检查可以有效提高宫颈癌前病变和癌变的检出率,对于及时发现癌前病变、防治宫颈癌具有重要意义。

Objective：To explore the diagnostic values of liquid-based cytology test and colposcopy in screening of cervical lesions.Methods：Liquid-based cytology test of cervical smears was used for screening of cervical lesions,the cases with abnormal results of cytological screening received colposcopy and pathological biopsy under colposcope.Results：2 066 cases received liquid-based cytology test,112 cases were found with positive cytological diagnosis,accounting for 5.42%,including 61 cases of atypical squamous cells of unknown significance（ASCUS）（2.95%）,36 cases of low grade squamous intraepithelial lesion（LSIL）（1.74%）,15 cases of high grade squamous intraepithelial lesion（HSIL）（0.73%）.Colposcopy and pathological biopsy under colposcope found 88 cases with abnormal colposcopic images（78.57%）.Compared with the results obtained from pathological diagnosis,42 cases with AUCUS（32 cases with CIN Ⅰ,8 cases with CIN Ⅱ,2 cases with CIN Ⅲ）,33 cases with LSIL（23 cases with CIN Ⅰ,7 cases with CIN Ⅱ,2 cases with CIN Ⅲ,1 case with SCC）and 13 cases with HSIL（5 cases with CIN Ⅱ,7 cases with CIN Ⅲ,1 case with SCC）were found.Conclusion：Liquid-based cytology test assisted colposcopy may increase the detection rates of cervical precancerous lesion and cervical carcinoma effectively,which have important values for diagnosis of precancerous lesion,prevention and treatment of cervical carcinoma timely.