液基细胞学联合阴道镜检查在宫颈癌筛查诊断中的临床价值

Clinical value of liquid based cytology test in comparison with vaginoscopy histology in the diagnosis of cervical lesions

目的探讨液基细胞学联合阴道镜检查在宫颈癌筛查诊断中的临床价值,为提高早期宫颈癌筛查结果的准确性提供参考依据。方法选择2011年1月-2012年12月简阳市妇幼保健院妇科门诊及妇女病普查体检的36 308名妇女作为筛查诊断对象,所有对象均进行液基细胞学(TCT)检查,TCT检查结果为低度鳞状上皮内病变(LSIL)者再进行阴道镜检查,并根据情况行阴道镜下宫颈活检病理检查进行确诊。结果在36 308名接受TCT检查的妇女中有1822例TCT结果为LSIL,检出率为4.4%。其中无明确意义的非典型细胞(ASC-US)872例(2.40%),LSIL 263例(0.72%),高度鳞状上皮内病变(HSIL)89例(0.25%),鳞癌(SCC)42例(0.14%)。TCT检查结果异常者中有1600例接受了阴道镜检查及活检,其中病理检查结果异常(CIN1及以上)者占90.75%。TCT检查结果为LSIL的妇女中,病理结果异常检出率为69.71%,检查结果为HSIL病理结果异常检出率为83.95%,结果为SCC病理结果异常(CIN2及以上者)检出率为42.86%,结果为ASC-US病理结果异常检出率仅占39.0%。结论 TCT联合阴道镜检查在宫颈癌筛查可以提高宫颈癌前病变和癌变的检出率,尽早诊断宫颈癌,为手术创造最佳时机。

[ Objective ] To study the clinical value of liquid based cytology test compared with vaginoscopy histology in the diagnosis of cervical lesion. [ Methods ] 36308 cases were received physical examination of women＇s disease from January 2011 to December 2012 in our hospital,all of them were received liquid based cytology test,and then received vaginoscopy test If the TCT result is LSIL and further biopsy test to confirmed cervical cancer. [ Results ] 36308 cases women were received TCT test and 1822 cases （4.4%）were LSIL,among them 872cases（2.40%） were ASC-US,263 cases（0.72%） were LSIL,89 cases（0.25%） were HSIL,42cases （0.14） were SCC. There are about 1600cases received vaginoscopy biopsy test,the result of 1452 cases were abnormal. About 69.71% cases were LSIL and CINI after liquid based cytology test and vaginoscopy histology. 83.95% were HSIL,42.86% were SCC,39.0% were ASC-US based TCT test. [ Conclusion ] Adjunctive TCT can enhance the sensitivity and accuracy of the diagnosis of cervical leision by vaginoscopy and biopsy, carrying out vaginoscopy and biopsy as early as possible can earn much opportunity to diagnose cervical cancer early.