不同细胞学检查方案在宫颈癌筛查中的应用效果探讨

Application effect discussion of different cytological examination project in cervical cancer screening

目的：探讨液基薄层细胞学技术（TCT）与巴氏涂片在宫颈癌筛查中的应用效果.方法：选择2015年12月～2016年12月于我院行宫颈癌筛查的820例女性作为研究对象,对其进行传统巴氏涂片筛查及TCT筛查.根据2001年TBS分级系统结合组织活检病理学报告的诊断标准对比两组检测方法诊断符合率.结果：TCT检测低度鳞状上皮内病变（LSIL）、 不典型鳞状上皮细胞（ASC）的符合率及总阳性符合率分别为96.88％、98.00％、98.18％,高于巴氏涂片检测的56.25％、60.00％、63.64％,对比差异具有统计学意义（P〈0.05）.TCT组中检测鳞状细胞癌（SCC）、 高度鳞状上皮内病变（HSIL）的符合率为100.00％、100.00％,与巴氏涂片组的70.00％和83.33％对比差异无统计学意义（P〉0.05）.结论：与传统巴氏涂片检测相比,TCT在宫颈癌筛查中具有更高的准确性,临床指导价值显著,可作为实用性较高的宫颈癌筛查方法进行推广.

Objective： To investigate the effect of liquid-based thin-layer cytology （TCT） and Pap smear＇in cervical cancer screening. Methods： 820 women with cervical cancer screening from December 2015 to December 2016 were selected as the study subjects, and the traditional Pap smear and TCT screening were performed. According to the diagnostic criteria of TBS grading system in 2001 combined with histopathology, the diagnostic criteria were compared between the two groups. Results： The coincidence rate and total positive rate of TCT in diagnosing low grade squamous intraepithelial lesion （LSIL） and atypical squamous epithelial cells （ASC） was 96.88%, 98.00% and 98.18%, higher than that of Pap smear which was 56.25%, 60.00% and 63.64%. The difference was statistically significant （P〈0.05） . The coincidence rates of TCT in detecting squamous cell carcinoma （SCC） and high grade squamous intraepithelial lesion （HSIL） were 100.00% and 100.00%, with that in Pap smear group at 70.00% and 83.33%, and the difference was not statistically significant （P〉 0.05） . Conclusion： Compared with the traditional Pap smear test, TCT in cervical cancer screening has a higher accuracy, clinical guidance value is significant, and can be promoted as a high practical cervical cancer screening method.