液基细胞学与传统巴氏制片技术在宫颈癌及癌前病变早期筛查中的应用

Application of liquid based cytology and traditional papanicolaou smear in cervical cancer and precancerous lesions

目的探讨宫颈癌及癌前病变早期筛查中液基细胞学（TCT）与传统巴氏制片技术的临床应用价值,并比较两种制片技术的制片质量情况。方法对2012年12月-2013年12月北京军区总医院（以下简称＂我院＂）门诊行宫颈液基细胞学检查的6114例妇女作为研究对象（TCT组）,并随机抽取2011年11月-2012年11月于我院行传统巴氏涂片检查的6826例妇女作为对照（传统巴氏涂片组）,观察阳性检出率、敏感度、特异度和制片质量。结果 TCT组检出异常细胞（ASC-US及以上病变）4601例,检出率为75.25%（4601/6114）,传统巴氏涂片组检出异常细胞（巴氏ⅡB级以上病例）4232例,检出率为62.00%（4232/6826）,TCT组与传统巴氏涂片组异常细胞检出者均行宫颈组织病理活检,TCT阳性者4215例,其敏感度为84.28%,特异度为65.32%;巴氏涂片阳性者4232例,敏感度为68.80%,特异度为47.87%。TCT组检查异常细胞的检出率、敏感度及特异度明显优于传统巴氏涂片组,二者比较差异有统计学意义（P〈0.05）。TCT组标本满意度为95.31%,传统巴氏涂片组标本满意度为75.90%,TCT制片质量优于传统巴氏制片技术（P〈0.05）。结论 TCT制片技术在宫颈癌及癌前病变早期筛查方面明显优于传统巴氏制片技术。TCT制片技术作为早期筛查宫颈癌及癌前病变的合适检查诊断方法,具有较高的临床实用性,并提高了检出率,减少假阴性率的发生。

Objective To intvestigate the clinical application value of the cervical liquid based cytology and traditional papanicolaou smear in early screening for cervical cancer and precancerous lesions and the production quality of two kinds of production technology. Methods From December 2012 to December 2013, 6114 women taken the examination of cervical liquid based cytology（TCT） in General Hospital of Beijing Military Region（＂our hospital＂ for short） were selected as the liquid cell group, and from November 2011 to from November 2012, 6826 women taken the detection of the traditional papanicolaou smear in our hospital were selected as the control group. The positive rate, sensitivity,specificity and quality of the production were observed between the two groups. Results Abnormal cells detected in TCT group were 4601 cases（ASC-US or more）, and the positive rate was 75.25%（4601/6114）, while abnormal cells detected in traditional papanicolaou smear group（more than grade ⅡB of papanicolaou or more） were 4232 cases, and the positive rate was 62.00%（4232/6826）. Patients with abnormal cells positive detected by underwent cervical biopsy in two groups. 4215 cases in TCT group was positive, and the sensitivity was 84.28%, specificity was 65.32%; 4232 cases in traditional papanicolaou smear group was positive, the sensitivity was 68.80%, specificity was 47.87%.The sensitivity, specificity and detection rate of abnormal cell in TCT group was higher than those of the traditional papanicolaou smear group, and the differences were statistically significant（P 0.05）. Degree of satisfaction of the pecimens in TCT group was 95.31%, it was 75.90% in traditional papanicolaou smear group, and it was better in TCT group than in traditional papanicolaou smear group. Conclusion Liquid based cytology production technology are clearly superior to traditional pap production technology in early screening for cervical cancer and precancerous lesions. Liquid based cytology production technology is an ideal early screening method for cervical cancer screening diagnosis, and it has important clinical value, effectively reduce the happening of the miss rate and false negative rate, worthy of promotion and popularization in clinical.