TCT、阴道镜下活体组织活检在宫颈疾病筛查中的临床应用

TCT, living tissue biopsy under colposcope in screening of cervical diseases and its clinical application

目的探讨薄层液基细胞学(TCT)、阴道镜下活体组织活检(活检)在宫颈疾病筛查中的临床应用。方法收集2011年1～12月在我院妇科门诊行TCT检查者共6 835例,且对选择TCT异常并同时行阴道镜下活检的269例患者资料进行了回顾性分析。结果在实施TCT检查的6 835例中,发现细胞学异常476例(约占6.96%),其中ASC-US 338例(占4.95%),ASC-H 16例(占0.23%),LSIL 79例(占1.16%),HSIL 35例(占0.51%),AGC 8例(占0.12%)。施行阴道镜下活检患者269例,组织学CIN检出率114例(42.38%),而CINⅡ及更高级宫颈病变检出率ASC-U为6例(4.35%),ASC-H为9例(56.25%),LSIL为11例(12.3%),HSIL为23例(65.71%);其中浸润癌3例(8.57%),AGC 3例(37.50%),1例腺癌(12.50%)。结论 TCT作为初筛手段是高效的,但须经阴道镜检查验证宫颈病变是否存在,并需在其指引下取宫颈组织活检确诊。

Objective To explore the TCT, the colposcopic biopsy （biopsy） in cervical disease screening clinical ap- plication. Methods Collected from January 2011 to December of 6 835 cases in our hospital gynecology clinic line TCT examination and selection TCT exception while line 269 colposcopic biopsy patients were retrospectively ana- lyzed. Results Checked the implementation of TCT 6835 cases found cytological abnormalities 476 cases. 269 cases of applying colposcopic biopsy patients, Histological CIN detection rate of 114 cases, CIN H and more advanced cervical lesion detection rate ASC-U 6 cases, ASC-H for 9 cases, LSIL 11 cases, HSIL 23 cases. Conclusion TCT efficient as a primary screening, but shall be subject to verification of colposcopy cervical lesions exists, and the need to take cer- vical biopsy-confirmed.