FSC-811法复查宫颈TCT检查阳性病例的结果分析

Reexamination and comparison of TCT-Positive cases using FSC-811

目的利用FSC-811(简称FSC)检查法复查宫颈液基薄层细胞检查(thin-cytologic test,TCT)阳性病例的结果进行分析,比较两种方法的诊断结果及诊断时间。方法选择TCT检查中诊断具有不典型宫颈细胞的病例,对其标本同时运用FSC检查法复查,两种方法均采用膜式制片法,前者行巴氏染色,中性树胶封固;后者用FSC试剂盒行酶标记,衬染试剂衬染,PVA封固。所有玻片由一名副高医师阅片,并隔周后无排序2次阅片,均分别登记诊断结果及阅片使用时间。结果与巴氏染色相比,FSC染色较易寻找阳性细胞,阅片时间短,检测诊断结果的可重复性高。对不能明确意义的非典型鳞状上皮细胞(atypicalsquamous cells of undetermined significance,ASCUS)诊断率减少,低度鳞状上皮内病变(low grade squamous intraepithelial lesion,LSIL)阳性率明显升高,高度鳞状上皮内病变(high grade squamous intraethelial lesion,HSIL)及鳞状细胞癌(squamous cell carci-noma,SCC)阳性率持平。结论 FSC与TCT检查对于宫颈病变中HSIL及SCC的筛查的稳定性相同,前者对LSIL诊断的阳性率高,而对ASCUS的诊断率较后者略低。FSC较TCT-巴氏诊断所用的时间短,诊断的可重复性高,体现了在疾病筛查中的优势。同时对于因炎症、微生物或上皮萎缩等因素引起的细胞变异等容易筛除,减少患者不必要的忧虑。

Purpose To reexamine TCT-positive cases using FSC-811 method and to compare the diagnostic result and time course. Methods All the cervical samples were stored in FSC-811 preservative solution. 2 cervical specimans on glass slides were prepared from every sample using a TCT machine. One speciman was subjected to FSC-811 stain and the other was subjected to routine Pap stain simultaneously. All the specimans were estimated by a vice-senior professional physician, and then those were estimated again after a week in an out-of-order way, at the same time, recording the dianostie results as well as the time coures for reading the specimans. Re- suits Compared to Pap stain method, it was easier to find positive stained cells, and was of shorter reading time, more than those, the diagnosis was more repeatable with FSC-811 method, the relative ratio of ASCUS was lower, but that of LSIL significantly rose, and that of HSIL and carcinoma seemed balance. Conclusion FSC-811 can give stable results on diagosis of HSIL and carcinoma as TCT- Pap stain did, and presented a higher LSIL and a lower ASCUS ratio. FSC-811 also showed the advantages over Pap stain on its short diagnostic time course and on repeatable results. Meanwhile, it is easier to exclude the misleading abnoImal cells caused by inflamma- tion, microorganism invasion or epithelial atrophy, so that, it could reduce the unnecessary anxiety of the patients.