TCT筛查中ASC-H的阴道镜检查及组织病理活检的对照研究

Comparative study between colposcopy and tissue biopsy in the diagnosis of ASC-H in TCT

目的:探讨新柏氏液基细胞学检测(Thinprep cytologic test,TCT)在诊断非典型鳞状细胞、不除外高级别鳞状上皮内病变细胞(atypical squamous cells,cannot exclude high-grade squamous intraepithelial lesion,ASC-H)中的诊断意义及临床处理建议。方法:收集2009年1月至2013年3月TCT标本中诊断为ASC-H者118例,对ASC-H患者进行阴道镜检查和阴道镜下活检,最后分析阴道镜检查与阴道镜下组织病理活检结果的关系。结果:118例TCT诊断为ASC-H的患者行阴道镜检查,其中98例行病理活检诊断对照。病理诊断结果为黏膜慢性炎患者10例(10.2%),人乳头瘤病毒感染8例(8.2%),宫颈上皮内瘤样病变I级(cervical intraepithelial neoplasia I,CIN I)17例(17.3%),CIN II 25例(25.5%),CIN III 28例(28.6%),浸润性鳞状细胞癌10例(10.2%)。结论:TCT筛查中如诊断为ASC-H,则高度提示宫颈鳞状上皮内瘤变的存在。ASC-H患者应该及时行阴道镜检查及阴道镜下活检以明确诊断,防止漏诊或过度诊断。

Objective： To explore the clinical significance and treatment recommendations in the diagnosis of atypical squamous cells with no exclusion of high-grade squamous intraepithelial lesion （ASC-H） in Thinprep cytologic test （TCT）. Methods： A total of 118 TCT specimens were collected from the patients diagnosed as ASC-H from January 2009 to March 2013. ASC-H patients were all treated with colposcopy and biopsy under colposcopy. Finally, the relationship between colposcopy and biopsy results was analyzed. Results： Among the 118 patients of ASC-H, the biopsy obtained from 98 patients was served as the control. There were 10 cases of chronic cervicitis （10.2%）, 8 cases of human papilloma virus （HPV） infection （8.2%）, 17 cases of cervical intraepithelial neoplasia I （CIN I） （17.3%）, 25 cases of CIN II （25.5%）, 28 cases of CIN III （28.6%）, 10 cases of squamous cell carcinoma （10.2%）. Conclusion： ASC-H can efficiently distinguish the presence of cervical squamous intraepithelial neoplasia. To prevent misdiagnosis or overdiagnosis, ASC-H patients should be timely carry out colposcopic biopsy under colposcopy.