液基细胞学检查在不同年龄段女性子宫颈癌前病变筛查中的现状研究

The Status of TCT Screening in Cervical Precancerous Lesionsamong Different Age Groups of Women

目的探讨不同年龄段液基薄层细胞学筛查在宫颈癌与癌前病变中的价值。方法通过对2018年1月至2018年12月常规体检的健康体检者共46770例,进行回顾性研究,按照TBS诊断标准进行分类与诊断。对ASCUS及以上诊断者行阴道镜检查,必要时行宫颈组织活检并以病理结果为标准。按年龄段分析TCT筛查结果与组织病理学结果的一致性,从而预测TCT在宫颈病变筛查中的价值。结果46770例健康体检者中TCT阳性者占比为31.16%。在不同的年龄段中,31~50岁年龄段属于TCT筛查阳性率的高发年龄段。对6587例病理诊断结果阳性分析发现在不同年龄段,两者符合率存在不一致性,31~40和41~50岁年龄段符合率最高,CINIII为最常见的活检病理诊断结果;<20岁年龄段的TCT筛查阳性率,以及与组织活检病理结果的阳性符合率和>60岁年龄段相近。结论宫颈病变确诊的阳性符合率并不严格遵循TCT筛查结果,其严重程度有随年龄增长而加重的趋势。宫颈病变TCT筛查检测在注重31~50岁年龄段的同时,也需要关注<20岁年龄段和>60岁年龄段,以期发现宫颈癌早期病变,降低发病率和死亡率。

Objective To investigate the value of liquid-based thin-layer cytology screening(TCT)in cervical cancer and precancerous lesions in different age groups.Methods A retrospective study was conducted on 46770 subjects who underwent routine physical examination from January,2018 to December,2018,and the subjects were classified and diagnosed according to TBS diagnostic criteria.Colposcopy and cervical biopsy were performed on patients with ASCUS and Other abnormal results,and pathological diagnostic results were used as the positive criteria for TCT screening.The consistency of TCT screening results with histopathological findings was analyzed by different age groups to predict the value of TCT screening for cervical lesions.Results Among 46,770 subjects,the positive TCT screening results accounted for 31.16%.Among different age groups,the 31-50 group was a high-risk population.As for 6,587 cases,the inconsistency in positive coincidence rate of TCT screening and tissue biopsy in different age groups existed,with the highest rate in 31-40 and 41-50 age groups.CINIII was the most common positive biopsy pathological diagnostic item.The TCT screening positive rate and positive coincidence rate with biopsy pathological results were similar in the age range of<20 and>60 years.Conclusion The positive diagnosis rate of cervical lesions does not conform to the severity of TCT screening results,even if there is a tendency to increase with age.Besides TCT screening test for cervical lesions being focused in 31-50 age group,we need to also pay attention to<20 and>60 years population.This guideline can contribute to the early detection of cervical cancer lesions,and reduce corresponding morbidity and mortality.