24687例宫颈液基薄层细胞学检查结果分析

A study of 24687 cases of cervical thin-prep cytology test

目的探讨液基细胞学检查(thin-prep cytology test,TCT)在宫颈病变筛查中的价值。方法对本院24687例进行TCT检查的病例结果进行分析,并对其中有相应宫颈活检病理结果的338例进行对照分析。结果 24687例TCT样本中,阳性病例680例,有阴道镜活检病理结果者338例。其中TCT检查结果为ASC-US者267例,经活检证实为阳性者107例(40.1%),其余ASC-H、LSIL、HSIL分别为20/23(87.0%),38/44(86.4%),4/4(100%)。结论 TCT检查判断为ASC-H,LSIL及HSIL者,与病理活检结果符合率较高,ASC-US阳性的病例与活检符合率稍低,需要进一步研究完善。

Objective To evaluate the clinical value of thin-prep liquid-based cytology test （TCT） for diagnosis of cervical lesions. Methods A total of 24687 patients who underwent TCT for screening of cervical lesions in our hospital were enrolled. A proportion of patients with positive cytology results were further examined by colposcopy-directed biopsy. Results TCT results showed that 680 （2.75%） cases had abnormal cervical squamous epithelial lesions. Colposcopy-directed biopsy results were available in 338 cases. Among 267 cases with ASC-US diagnosed by TCT, 107 （40.1%） were definitely confirmed by colposcopy-directed biopsy. Moreover, the consistent rates of diagnosis between TCT and colposcopy-directed biopsy were 87.0% （20/23） for ASC-H, 86.4% （38/44） for LSIL, and 100% （4/4） for HSIL, respectively. Conclusion TCT has high agreement with biopsy in cases of ASC-H, LSIL and HSIL. The consistent rate of diagnosis between ASC-US and colposcopy- directed biopsy remains unsatisfactory and needs further investigations.