液基细胞学检测在基层医院宫颈病变筛查中的应用

Application of Liquid-based Thinprep Cytologic Test in Screening of Cervical Lesions in Primary Hospital

目的探讨宫颈液基细胞学(TCT)在基层医院宫颈病变筛查中的应用价值。方法按照现行国际通用TBS分类系统,整理和收集我院6415例患者TCT检测结果;液基细胞学阳性的患者行宫颈活体组织检查,以组织学诊断结果为标准,分析细胞学诊断与组织学诊断的符合情况。结果 6415例妇女液基细胞学检查中,检测出阳性病例242例(ASC-US、ASC-H、LSIL、HSIL、SCC),阳性比率为3.78%;其中125例异常液基细胞学结果进行宫颈组织活检,LSIL与CINⅠ级符合率为95.23%(40/42),两者差异无统计学意义(P>0.05);HSIL与CINⅡ/Ⅲ级符合率为98.67%(74/75),二者差异无统计学意义(P>0.05);SCC诊断符合率为90%(9/10)。结论液基细胞学在宫颈病变筛查中应用,对宫颈早期病变,甚至隐匿性病变能及早发现,从而采取及时的治疗,有效的阻止了病变的进一步发展,最大限度的降低我国宫颈癌的发病率和死亡率,且与组织病理诊断结果符合率较高,是有效宫颈病变的检测方法,值得基层医院的广泛应用。

Objective To explore the application value of liquid-based thinprep cytologic test （TCT） in diagnosis of cervical cancer and precancerous lesions. Methods A retrospective analysis of 6415 cases of cervical liquid- based thinprep cytologic test by the current international TBS classification system was to calculate tile coincidence rate between the positive results of liquid- based thinprep cytologic tesl and cervical biopsy results. Results The liquid- based thinprep cytologic test showed that there were 242 cases of atypical squamous ceils of undetermined significance（ASC-US ） , the positive rate was 3.78%, including 98 cases of ASC-US（l.53%）, 24 cases of ASC-H （0.38%）, 40 cases of LSIL （0.63%） ,71 cases ofHSIL （1.11%） and 9 cases of SCC （0.14%） ; of which 125 cases of abnormal cytology results of cervical biopsy, LSIL and CIN I coincidence rate was 95.23% （40/42）, there was not significant statistically difference （P〉0. 05） ; HSIL and CIN Ⅱ /Ⅲ coincidence rate was 98.67% （74/75）, there was not significant statistically difference （P〉0.05）; SCC coincidence rate was 90% （9/10）. Conclusion The positive rate of detecting by the liquid-based thinprep cytologic test and the coincidence rate between cervical biopsy and TCT are higher; it is an effective method for detecting early cervical lesions.