液基细胞学联合组织病理学检查对宫颈病变的诊断价值

Value of liquid-based cytology combined with histopathological in the diagnosis of cervical lesions

目的探讨液基薄层细胞制片技术（TCT）联合阴道镜及阴道镜下宫颈活检对宫颈病变的诊断价值。方法回顾性分析11 361例患者的TCT检查结果并行TBS细胞学分类诊断,对部分TCT检查阳性的患者行阴道镜活检及组织病理学检查。结果 11 361例涂片中发现阳性涂片638例（5.62%）,其中不典型鳞状细胞（ASC）355例（3.12%）,低度鳞状上皮内病变（LSIL）219例（1.93%）,高度鳞状上皮内病变（HSIL）39例（0.34%）,鳞状细胞癌（SCC）2例（0.02%）。30~39岁年龄组阳性涂片所占比例最高37.77%（241例）。638例细胞学阳性的病例中有390例在本院行阴道镜下宫颈活检,TCT阳性涂片与活检病理检查结果对照阳性率及符合率分别为SCC 100%,100%;HSIL 100%,83.33%;LSIL68.60%,62.32%。结论 TCT技术联合阴道镜活检组织病理学检查是筛查和诊断子宫颈癌及其癌前病变的可靠手段。

Objective To study the value of thinprep cytology test（TCT） combined with the results of cervical biopsy by colposcopy in diagnosis of cervical lesions.Methods Retrospective analysis of 11 361 cases examined with TCT and TBS diagnosis,some positive cases with TCT did cervical biopsy by colposcopy and histopathological examination.Results There were 638 positive cases of 11 361 cases,the positive ratio was 5.62%,and were mainly distributed during the age of 30 to 39.Among them,390 cases were analyzed with pathologic biopsy by colposcopy,and to be divided into the following subsets： 355 cases for atypical squamous cell（ASC,3.12%）,219 cases for low-grade squamous intraepithelial lesion（LSIL,1.93%）,39 cases for high-grade squamous intraepithelial lesion（HSIL,0.34%）,2 cases for squamous cell carcinoma（SCC,0.02%）.Compared with the positive rate and coincidence rate from the pathologic diagnosis,SCC 100%,100%;HSIL 100%,83.33%;LSIL 68.60%,62.32%.Conclusion TCT technique combined with cervical biopsy by colposcopy is a reliable means to screen and diagnose cervical cancer and precancerous lesions.