宫颈TCT与活检诊断的符合率及其影响因素分析

Analysis of coincidence rate between cervical thinprep cytology test and cervical biopsy diagnosis and its influencing factors

目的 探讨宫颈薄层液基细胞学（TCT）判读与活检病理诊断的符合率,并分析其影响因素.方法 对2010年期间在我院进行薄层液基细胞学检查的病例进行回顾性研究,并与活检病理诊断进行对比分析.结果 宫颈上皮异常检出率为3.54%,55岁以上妇女上皮异常检出率明显低于46~55岁组.薄层液基细胞学判读与病理诊断的符合率为77.55%,存在判读偏低或偏高的现象.导致判读偏差的因素有细胞学取材局限,难以获取深层细胞;取材不当以致阳性细胞过少;活检取材不到位等.结论 薄层液基细胞学检查是宫颈癌筛查的有效方法,对于宫颈上皮异常,包括非典型鳞状上皮,意义不明确的病例必须进行细胞学复查、检测人乳头瘤病毒或活检,对于薄层液基细胞学判读阳性而病理诊断阴性的病人也需进一步追踪以防漏诊.

Objectlve To study the coincidence rate between cervical thinprep cytology test （TCT） and cervical biopsy pathohistology diagnosis and analyze the influencing factors. Methods All of the cases taking TCT in the hospital in 2010 were reviewed and compared with the results of biopsy pathological diagnosis. Results The detection rate of abnormal cervical epithelium was 3.54%, and the rate was obviously lower in women over 55 than that in women aged 46-55 years. The coincidence rate between TCT and pathohistological diagnosis was 77.55%, and the interpretation of TCT was higher or lower, which might be resulted from lacking cells in deeper layers, small quantity of positive cells, and the failure of obtaining positive tissue in biopsy. Conclusion TCT is an effective method of cervical cancer screening. The cases of abnormal epithelium including ASCUS should be rechecked with TCT, HPV detecting or biopsy, and the patients of positive TCT but negative pathological examination should be followed to avoid missing diagnosis.