颈管细胞和化生鳞状上皮细胞在宫颈病变检测中的意义

Significances of endocervical cells and metaplastic squamous epithelial cells in detection of cervical lesions

目的:调查宫颈液基细胞学检测中颈管细胞(EC)和化生鳞状上皮细胞(MSC)的有无是否与鳞状上皮内瘤变的检出相关,并分析EC和MSC的有无与经活体组织检查(活检)证实的病理结果之间的关系。方法:2008年1月～2010年12月17 815例宫颈液基细胞学涂片被列入研究。将液基细胞学标本中的上皮细胞成分与筛查结果进行统计,比较不同细胞成分下ASCUS、LSIL和HSIL的检出率,并对细胞成分与宫颈活检结果的关系进行分析。结果:总体中ASCUS检出率为4.95%,60～69岁组检出率最高(9.55%);LSIL总检出率为0.27%,40～49岁组检出率最高(0.42%);HSIL总检出率为0.19%,40～49组检出率最高(0.36%)。各年龄组细胞学异常总检出率均以EC(+)/MSC(+)组为最高,其次是EC(-)/MSC(+)组;ASCUS、LSIL及HSIL三组中经病理活检结果证实为CIN2及以上者比例最高组均为EC(-)/MSC(+),三组中所占比例分别为27.41%、50.00%、83.33%;EC(+)/MSC(+)次之,三组中所占比例分别为12.43%、42.85%、80.00%;结论:EC及MSC存在状态对宫颈细胞学异常的总检出率有影响,其中MSC与HSIL之间的关联更强。

Objective： To investigate whether endocervical cells and metaplastic squamous epithelial cells are associated with the detection of squamous intraepithelial neoplasia, analyze the relationship between the presences or absences of endocervieal cells, metaplastic squamous epithelial cells and pathological findings confirmed by cervical biopsy. Methods： A total of 17 815 cervical liquid -based cytologi- cal smears were included into the study. The epithelial component in cytological samples and screening results were analyzed statistically, the detection rates of ASC - US, LSIL, and HSIL in different cellular components were compared, the relationship between cellular components and cervical biopsy results was analyzed. Results： The total detection rate of ASC -US was 4. 95%, and the detection rate of AC -US in 60 -69 - year - old group was the highest （9. 55% ） ; the total detection rate of ISIL was 0. 27% , and the detection rate of ISIL in 40 -49 - year - old group was the highest （0. 42% ） ; the total detection rate of HSIL was 0. 19%, and the detection rate of HSIL in 40 -49 - year - old group was the highest （ 0. 36% ） . Among the cases in different age groups, the total detection rate in endoeervical cells （ ＋ ） / metaplastic squamous epithelial cells （ ＋ ） group was the highest, followed by endocervieal cells （ - ） / metaplastic squamous epithelial ceils （ ＋ ） group; among the cases with ASC - US, ISIL, and HSIL, the detection rate of CIN II and above lesions in endocervical cells （ - ） / metaplastic squamous epithelial ceils （ ＋ ） group was the highest, the proportions in the three groups were 7.41% , 50.00% , and 83.33% , respectively; followed by endocervical cells （ ＋ ） / metaplastie squamous epithelial cells （ ＋ ） group, the proportions in the three groups were 12. 43%, 42. 85%, and 80. 00% , respectively. Conclusion： The existing states of endocervical ceils and metaplastic squamous epithelial cells had impact on the total detection rate of cervical cytological abnormalities, and the correlation between metaplastic squamous epithelial ceils and HSIL was more stronger.