宫颈癌及癌前病变筛查假阳性和假阴性分析及质量控制的探讨

Investigation on false-positive and false-negative diagnosis of cervical cancer and precancerous lesion screening and their quality control

目的分析宫颈液基细胞学检查中假阳性及假阴性产生的原因,探索对其进行质量控制的方法。方法在1 018例有组织对照的宫颈液基细胞片中,检出24例假阳性和15例假阴性片,复阅其细胞学和组织学,结合高危HPV检测及随访,分析假阳性、假阴性产生的原因。结果假阳性产生的原因分别为细胞学和组织学的误诊漏诊(9例),未取到病变组织(10例),细胞学判断的主观差异(5例);假阴性产生的原因分别为取材不当(5例),制片染色不佳(2例),细胞学和组织学误诊(6例),形态学判断主观差异(2例)。结论宫颈细胞学假阳性、假阴性的产生涉及检查的各环节,需要对各环节做好质量控制。

Objective To investigate the causes of false-positive and false-negative results in liquid base cytology test for cervical cancer or precancerous lesion,to explore their quality control method. Methods Falsepositive（24 cases） and false-negative（15 cases） cervical cytology cases in 1 018 cases were found and reviewed corresponding histopathological section,combined with high-risk Human papillomavirus test and follow-up,analyzed the causes of false-positive and false-negative results. Results The causes of false-positive diagnosis were as follows ：9 cases cytological or histological false diagnosis and missed diagnosis,10 cases not collecting cervical lesion,5 cases subjective difference of cytological diagnosis. The causes of false-negative diagnosis were as follows ：5 cases collecting specimen incorrectly,2 cases poor staining,6 cases cytological and histological false diagnosis,2 cases subjective difference of morphologic judgement. Conclusion Every phase of cervical cytology screening is involved in falsepositive and false-negative diagnosis. Quality control must be performed to every procedure.