宫颈液基细胞学检查结果分析

ANALYSIS ON RESULT OF CERVICAL THINPREP CYTOLOGY TEST IN 2122 CASES

目的：探讨宫颈液基薄层细胞学检查（Thinprep cytologytest，TCT）与宫颈活检的符合率，结合宫颈活检在宫颈上皮性病变早期诊断中的临床应用价值。方法：回顾性分析2012年2122例妇科病人宫颈TCT结果。阳性病例共106例，其中74例行宫颈活检，比较细胞学与组织学结果。结果：2122例TCT检查中细胞学检查阳性率为5．0％，其中ASC—us73例（在阳性病例中占68．87％），ASC—H5例（4．71％），LSIL16例（15．09％），HSIL11例（10．38％），SCC1例（0．94％）；宫颈活检74例，其中炎性反应26例（35．14％），挖空细胞5例（6．76％），CINI级48例（64．86％），CINⅡ级3例（4．05％），CINm级7例（9．46％），鳞癌2例（2．7％），以组织学结果验证细胞学结果，符合率分别为LSIL（78．98％），HSIL（90．91％），SCC（100％）；并且宫颈病变多见于35—65岁年龄段。结论：宫颈TCT具有较高的准确性，是筛查宫颈上皮性病变的有效手段，结合阴道镜及宫颈活检进一步检查可使宫颈上皮内瘤变和宫颈癌得到早期诊断和早期治疗。

Objective：To exploit the diagnose accordance rate of the cervical thinprep cytology test （TCT） and tissue biopsy, and to investigate the clinical application value of the TCT technology combined with tissue biopsy in early screening for cervical epithelial lesions. Methods：The results of 2122 cases with cervical TCT inspection were retrospective analyzed. Patients with ASC-US or severe than ASCUS were defined as abnormal cytology according to Bethesda system for cytology classifications. Among 106 cases of abnormal cytology ,74 positive patiens received biopsy inspection. The cytology and histology results were compared, and the relationship of lesion and ages were analyzed. Results ：In 2122 cases of cervical TCT, the abnormal cytology ratio was 5.0%. Among them the ASC-US were 73 cases（68.9%）,ASC-H were 5 cases（4.71%）, LSIL were 16 cases （ 15.09% ）, HSIL were 11 cases （ 10.38% ）, and SCC were 2 cases （2.7%）. Among the 74 cases of biopsy,cases of inflammation reaction were 26 cases （35.14%）, koilocytotic cell 5 cases （6.76%）, CIN 1 48 cases （64.86%）, CIN 11 3 cases （4.05 % ）, CIN lU 7 cases （ 9.46% ）, squamous carcinoma 2 cases（2.7% ） ,revealing that the cytology results had a high conformity rate with biopsy results. And the onset age of cervical lesions was between 35 -65 years old. Conclusion： TCT technology is an effective method for the screening of cervical epithelial lesions with its high accuracy. Combined with TCT and tissue biopsy can greatly improve early diagnosis of CIN and pretent the arising of c cervical carcinoma.