健康体检人群宫颈细胞学筛查结果分析

The Result Analysis of Cervical Cytology Screening in the Health Examination Crowd

目的探讨液基薄层细胞学检查(thinprep cytology test,TCT)在健康体检人群宫颈病变中的应用价值。方法对2013年1月至2015年12月重庆医科大学附属第一医院健康体检部33 388例健康体检人群宫颈细胞学筛查结果进行分析,并将其中TCT阳性病例与其组织病理学结果进行比较。结果 33 388例液基细胞学检查样品中共检出TCT阳性468例(1.40%),其中未明确诊断意义的不典型鳞状上皮(ASC-US)病例167例(0.50%),不典型鳞状上皮细胞(ASC-H)病例13例(0.04%);低度鳞状上皮内病变(LSIL)107例(0.32%)、高度鳞状上皮内病变(HSIL)24例(0.07%)和非典型腺细胞无其他特殊意义(AGC-NOS)147例(0.44%);宫颈癌检出10例(含鳞状上皮癌6例,腺癌4例)(0.03%)。TCT检查结果与组织病理学检测结果的符合率为91.90%,两者比较差异无统计学意义(x^2=1.83,P>0.05)。宫颈病变年龄分布情况表明,CIN以上病变的高检出年龄段为31~40岁,鳞状上皮癌(SCC)的高检出年龄段为51~60岁,腺癌高检出年龄段为≥61岁。结论宫颈细胞学筛查能较好发现健康体检人群的早期宫颈上皮内病变,结合组织病理检测对宫颈癌的早发现、早诊断和及时干预治疗有重要意义。

Objective To investigate the application value of Thinprep cytology test（TCT）in the health examination crowd with cervical lesions.Methods The cervical cytology screening results of the 33,388 cases who had health examination in Medical Examination Centre of The First Affiliated Hospital of Chongqing Medical University from January of 2013 to December of 2015 were analyzed,and the screening results of TCT-positive cases were compared with the results of the histopathologic examination.Results 468TCT-positive cases（1.40%）were found among the 33,388 cases.Among those TCT-positive cases,there were 167cases（0.50%）with atypical squamous cells of undetermined signification（ASC-US）,13cases（0.04%）with atypical squamous cells of high grade-cervical lesion（ASC-H）,107cases（0.32%）with low-grade squamous intraepithelial lesions（LSIL）,24cases（0.07%）with high-grade squamous intraepithelial lesion（HSIL）,147cases（0.44%）with atypical glandular cell with no other special signification（AGC-NOS）,and 10cases（0.03%）with cervical cancer which included 6cases with squamous cell carcinoma and 4cases with adenocarcinoma.The coincidence between the results of TCT examination and the testing results of histopathological examination was 91.90%,and there were no significant differences between the results of the two test methods（x^2=1.83,P1.83）.The age distribution of the cervical lesions showed that the highest rate of CIN detection lied in the crowd with the age of 31 to 40,that of the squamous cell carcinoma（SCC）lied in those with the age of 51 to 60,and that of the adenocarcinoma lied in those over 61 years old.Conclusion Cervical cytology screening can detect the early cervical intraepithelial lesions in the health examination crowd and it has great significance in the early detection,early diagnosis and timely intervention of cervical cancer in combination with the histopathological detection.