704例宫颈鳞癌的液基薄层细胞学分析

Analysis on Thinprep cytology test in 704 cases with cervical squamous cell carcinoma

目的：探讨液基薄层细胞学（TCT）诊断宫颈鳞状细胞癌（SCC）的准确性，并分析漏诊原因。方法：回顾性分析2005年7月～2013年6月期间何贤纪念医院704例病理组织确诊为宫颈鳞状细胞癌且在确诊前1个月接受过液基薄层细胞学检查的病例。结果：704例液基薄层细胞学标本中，诊断为正常范围（WNL）8例（1．1％），未明确定义的不典型鳞状细胞（ASC—US）71例（10．1％），不能排除高度鳞状上皮内病变的不典型鳞状细胞（ASC—H）112例（15．9％），低级别鳞状上皮内病变（LSIL）69例（9．8％）、高级别鳞状上皮内病变（HSIL）226例（32．1％），鳞状细胞癌（SCC）218例（31．0％）。结论：液基薄层细胞学是宫颈疾病筛查的有效方法，但对宫颈鳞癌的直接诊断准确性不高，需改进诊断各个方面以降低误诊率。

Objective：To explore the accuracy of Thinprep cytology test （TCT） in diagnosis of cervical squamous cell carcinoma and analyze the causes of missed diagnosis, nethods：A total of 704 cases diagnosed as cervical squamous cell carcinoma definitely by pathologi- cal examination and undergoing TCT at one month before definite diagnosis in the hospital from July 2005 to June 2013 were analyzed retro- spectively. Results：Among 704 cases, 8 cases （1.1%） were diagnosed as within normal limits （WNL）, 71 cases （10. 1% ） were diag- nosed as atypical squamous cells of undetermined significance （ ASC-US）, 112 cases （ 15.9% ） were diagnosed as atypical squamous cells, cannot exclude high squamous grade intraepithelial lesion （ ASC - H）, 69 cases （9. 8% ） were diagnosed as low - grade squamous intraepi- thelial lesion （ LSIL）, 226 cases （32. 1% ） were diagnosed as high - grade squamous intraepithelial lesion （ HSIL）, 218 cases （31.0%） were diagnosed as cervical squamous cell carcinoma. Conclusion：TCT is an effective method for screening cervical diseases, but its accuracy for direct diagnosis of cervical squamous cell carcinoma is not high, more improvements are requested to reduce the misdiagnostic rate.