宫颈传统脱落细胞学结果与患者年龄及临床诊断相关性分析

THE RELATIONSHIP BETWEEN THE TRADITIONAL CERVIX CYTOLOGY AND THE PATIENT'S AGE AND CLINICAL DIAGNOSIS

目的分析异常宫颈传统细胞学与宫颈活检、年龄及临床诊断的相关性,增强医患双方对宫颈传统细胞学的认识,提高宫颈癌前病变的诊断率。方法回顾性分析13 771例宫颈传统细胞学,了解异常宫颈传统细胞学与宫颈活检、年龄及临床诊断的相关性。结果 13 771例宫颈传统脱落细胞学标本筛出异常者126例,其中ASC43例(34.13%),LSIL41例(32.54%),HSIL37例(29.37%),鳞状细胞癌5例(3.97%)。去除失访原因后,细胞学与病理活检符合率ASC为46.15%,LSIL为87.88%,HSIL为97.06%,鳞癌细胞为100.00%;宫颈传统细胞学结果异常而组织学为炎症患者共19例,其中宫颈鳞化或HPV感染者为14例(73.68%)。各年龄组均有宫颈细胞学异常出现。且20～35岁年龄组发现ASC10例,LSIL9例,HSIL10例,癌细胞1例,总数占异常细胞总量的23.81%。临床诊断与异常脱落细胞关系分析显示,宫颈炎56例(44.44%),宫颈不典型增生术后或宫颈癌术后13例(10.32%),接触性出血6例(4.76%),宫颈癌仅2例(1.59%)。结论宫颈癌前病变的发生有年轻化趋势,且临床症状表现多样。增强医患双方对宫颈传统细胞学的认识可以增加宫颈癌前病变的诊断率。

Al^tract Objective To analyze the relation between dysfunction of the traditional cervix cytology and cervical biopsy^age and clinical diagnosis, enhance the recognition of the traditional cervix cytology in doc- tors and patients for improving the diagnostic level of cervix lesion. Methods A retrospective analysis had been made on 13771 cases of the traditional cervix cytology to understand the relationship between dysfunc- tion of the traditional cervix cytology and cervical biopsy, age and clinical diagnosis. Results Total 126 ca- ses were positive in 13771 cases which were screened with the traditional cervix cytology,including ASC 43 cases（34. 13~）, LSIL 41 cases （32. 54~~）, HSIL 37 cases （29. 37~） and Cervix cancer cell 5 cases （3. 97~）. In the positive cases, there were 19 cases which were negative diagnosis by the cervix biopsy, including 14 cases of squamous cell metaplasia and/or HPV infection. Removing the missing cases, the co- incident rate of the results by the traditional cervix cytology and cervix biopsy was 46. 15~ for AS（;, 87. 88 for LSIL, 97.06 ~ for HSIL, 100.00 % for cervix cancer. There were positive cases among the differ- ent age groups~ ASC 10 cases, LSIL 9 cases, HSIL 10 cases and cervix cancer cell 1 cases were found in 20 ~35 age groups, accounting 23.81~ of the total positive cases. The relative analysis of clinical diagnosis and the positive of the traditional cervix cytology found cervicitis 56 cases （44.44~）, post - operation of a- typical hyperplasia and cancer of the cervix 13 cases（10.32 ~）, contact haemorrhage 6 cases （4.76~） and cervix cancer 2 cases（1.59%）. Conelasions Cervical lesion degree displays the tendency of young age and the multiplicity of the clinical symptom. To enhance doctors and patients can improve the diagnostic level the recognition of the traditional cervix cytology for of cervix lesion.