宫颈液基细胞学筛查假阳性160例分析

False positive results analysis of the cervical liquid-based preparation screening

目的：分析宫颈液基细胞学筛查假阳性结果的原因，以期提高宫颈细胞学诊断的准确性。方法收集宫颈液基细胞学筛查病例20353例，统计分析细胞学诊断结果，阳性结果的病例对比分析其组织学诊断结果，对其中160例细胞学诊断为阳性而组织学未检出肿瘤性病变的病例复习原细胞学片。结果20353例中，637例细胞学筛查为阳性，阳性病例中388例有组织学对照，其中228例组织学诊断有异常改变，包括：宫颈低级别上皮内病变（LSIL）、宫颈高级别上皮内病变（HSIL）、宫颈鳞状细胞癌（SCC）、宫颈腺癌（ACC）、子宫内膜样癌、恶性黑色素瘤；假阳性160例，占41．2％，活检未检出异常病变，主要集中于意义不明确的非典型鳞状细胞（ASC-US，占37．2％）和 LSIL（占2．8％）。结论宫颈液基细胞学筛查中造成假阳性的原因多样，实际工作中应采取规范化的工作流程，加强诊断医生的培训等措施，不断总结提高，尽可能避免假阳性诊断的产生。

Objective To analyze and summarize the cause of false positive results of the cervical liquid-based preparation screening,to improve the accuracy of cervical cytology diagnosis.Methods 20 353 cases were col-lected.The cytological diagnosis was statistically analyzed.Test positive results contrast analysis of the histologic diag-nosis was conducted.Cytological diagnosis of positive and histology diagnosis of non -neoplastic to review the original cytology.Results The incidence of 637 cases of cytology screening for positive.Among the 388 cases with histologic control,228 cases of histological diagnosis of abnormal change.Include：low -grade squamous intraepithelial lesion （LSIL）,high -grade squamous intraepithelial lesion （HSIL）,cervical squamous cell carcinoma （SCC）,cervical ade-nocarcinoma（ACC）,endometrioid carcinoma,malignamt melanoma.The other 160 cases did not check out the abnor-mal lesions.Conclusion Incidence of false positive results in 160 cases,accounting for 41.2%.It almost focused on atypical squamous cells of undetermined significance （ASC -US）and LSIL for a variety of reasons.Standardized work process should be taken to strengthen the training of the doctors,summarize continuously improve,as far as possi-ble to avoid false positive diagnosis.