3226例TCT结果分析及其质量控制

Analysis of 3 226 TCT Diagnosis Results and Its Quality Control

目的:探讨TCT(液基薄层细胞学)与阴道镜下活检的吻合程度,分析不同医生的诊断吻合度,最大限度提高TCT作为宫颈癌筛查手段的的准确性。方法:选取2007年2月至2010年9月期间来我院进行妇科体检TCT异常病例3 226人次的TCT诊断报告与阴道镜活检诊断结果进行比较,以病理活检作为最后诊断。结果:三位主治医生中甲的阅片吻合率为73.98%,乙的吻合率为77.04%,丙的吻合率为82.30%,总的吻合率为78.18%,三者间比较差异极显著(χ2=22.42,P<0.000 1)。结论:1)TCT细胞学检查与传统的细胞学方法相比取材方便,无创,确诊率高,是宫颈癌筛查的重要方法。2)医生经验在诊断过程中起重要作用,加强对医务人员的培养,适时培训是提高TCT确诊率的重要环节。

Objective：To research the identical degree between TCT and colposcopy biopsy,analyze the identical degree among different doctors,in order to maximize the accuracy of TCT as a means of screening cervical cancer.Methods：To compare the abnormal 3 226 TCT diagnosis reports which were extracted from physical examination reports during February,2007 to September,2010 and the medical results of colposcopy biopsy,and take as the final diagnosis with pathologic biopsy.Results：Three physician-in-charge have different inosculation rate,one is 73.98%,one is 77.04%,one is 82.30%,the total is 78.18%.There is an extremely significant difference among them（χ2=22.42,P0.000 1）.Conclusion：Compared with the normal cytology,TCT has advantages of convenience,no wounds,high diagnosis which is the important method to screen cervical carcinoma.The experience of the doctor on diagnosis is very important,strengthening the cultivation among doctors is also a major step in TCT diagnosis.