200例宫颈细胞学ASC-US诊断的形态学分析

Cell Morphological Analysis on 200 Cases Diagnosed ASC-US

目的根据宫颈组织病理诊断结果,分析细胞学诊断为ASC-US的涂片中异常细胞形态变化的特征。方法对细胞学诊断为ASC-US并建议临床活检的200例病例进行组织病理诊断,并回顾性观察、分析细胞学涂片中异常细胞的排列方式、细胞形态、细胞核形态、核染色质的分布等。结果细胞排列方式上,组织学诊断CINⅢ的细胞学涂片中异常细胞片状排列为72.69%,组织学诊断CIN I和CINⅡ的细胞学涂片中异常细胞为单个散在和片状排列平均分布,组织学诊断炎症的涂片中异常细胞单个散在为74.34%。细胞核形态和染色质分布方面,CINⅢ的细胞学涂片中异常细胞核不规则形态为16.35%,细胞核染色质不均匀粗颗粒分布为5.03%;炎症、CIN I和CINⅡ的细胞学涂片中异常细胞核则多为圆形或卵圆形,其中炎症、CIN I细胞学涂片中异常细胞核染色质以均匀的细颗粒分布多见,各占51.11%、55.18%,CINⅡ细胞学涂片中异常细胞核染色质以不均匀细颗粒分布多见,为53.66%。结论通过观察异常细胞的形态学指标,分析异常细胞形态变化的特征,可以对初步诊断为ASC-US的细胞涂片做出进一步判断。

Objective To study characteristics of the abnormal cell morphology changes in PAP smears diagnosed ASC-US according to the TBS.Methods 200 cases diagnosed ASC-US on cervical biopsies were biopsied.And the cell arrangement,cell shape,nuclear morphology,the distribution of nuclear chromatin in the abnormal cells were observed and analyzed.Results In the cell arrangement,sheet arranged as 72.69% of the abnormal cells in cytology smear of the histology diagnosis of CIN Ⅲ.The abnormal cells were sheet arranged with single scattered the evenly distributed of the histological diagnosis of CIN Ⅰand CIN Ⅱ.The rate of single scattered in abnormal cells was 74.34% for the histological diagnosis of inflammatory.In the nuclear morphology and chromatin distribution,abnormal nuclear of irregular shape and a coarse chromatin uneven distribution was 16.35%,5.03% in cytology smears of CIN Ⅲ.In inflammation and CIN Ⅰ,nuclear chromatin with uniform distribution of fine particles more common of abnormal cells in cytology smear,were accounted for 51.11%,55.18%,while in CIN Ⅱ,the rate of nuclear chromatin with non–uniform distribution of fine particles were 53.66% of abnormal cells in cytology smear.Conclusion The specific morphology indicators and the characteristics of morphology changes in abnormal cell by observing and analyzing,can be helpful to make further judgments for the initial diagnosis of ASC-US in cytology smear.