TCT对宫颈癌早期筛查及诊断的意义

The clinical significance of liquid-based thin-layer cells detection system(TCT)in the early screening and diagnosis of cervical cancer

目的通过与病理活体组织学检查比较,评价TCT对宫颈癌早期筛查的价值。方法选取妇科门诊就诊的患者238例和妇科普查人群289名共计527名进行TCT检查,行阴道镜检查后在宫颈选择宫颈鳞-柱状上皮交接部分3、6、9、12点或上皮细胞异常处取组织标本送病检。结果 (1)就诊患者组的TCT检查阳性率为65.13%(155/238),妇科普查组为56.06%(162/289)。(2)以病理诊断为金标准,计算结果显示TCT筛查CIN及宫颈癌的灵敏度为97.70%,特异度为95.00%,阳性预测率为79.43%,阴性预测率为99.52%,漏诊率为2.30%。结论 TCT能有效筛查出CIN,结合阴道镜下的活检和组织病理学检查能明显提高诊断的准确率,结果存在一定的假阳性和假阴性率。

Objective To evaluate value of liquid-based thin-layer cells detection system（TCT）on early screening for cervical cancer through comparison with pathologic diagnosis.Methods Five hundred and twenty seven people including 238 gynecological outpatients and 289 gynecological mass screening people were screened by TCT,all of them were given colposcopy examination and following pathologic diagnosis with tissues token at cervical squamous cell-columnar epithelial cell-columnar epithelial transformation zone at point 3,6,9,12 or abnormal epithelial cells zone.Results The positive rates of TCT examination was 65.13%（155/238）and 56.06%（162/289）in gynecological outpatient and gynecological mass screening people group respectively.Comparison with pathology diagnosis,the sensitivity of TCT was 97.70%,the specificity was 95.00%,the positive forecast rates was 79.43%,the negative forecast rates was 99.52%and the rates of missed was 2.30%.Conclusion TCT is effective in screening detection of CIN;it can significantly improve diagnostic accuracy combined with biopsy under colposcopy and pathological examinations.But it still has the fake positive rates and fake negative rates.