宫颈细胞蜡块制作方法在宫颈病变筛查中的比较研究

Comparative Study on the Methods of Making Cervical Cell Wax Blocksin the Screening of Cervical Lesions

目的比较三种不同的细胞蜡块制作方法在宫颈病变筛查中的作用,探索更好的宫颈细胞蜡块制作方法,提高诊断准确率,使患者在早期筛查中得到合理分流。方法收集柳州市工人医院2018年1月~12月妇科宫颈液基细胞学检测(TCT)剩余样本270例,其中炎症、低级别鳞状上皮内病变(LSIL)、高级别鳞状上皮内病变(HSIL),鳞状细胞癌(SCC)的病例,分别为148例、35例、72例、15例。将同一样本分为3份,分别用传统琼脂包埋法、琼脂温箱凝固包埋法、琼脂冷冻凝固包埋法进行细胞蜡块制备。比较三种方法制片效果、诊断阳性率及诊断的符合率。结果三种细胞蜡块制备方法对高级别以上病变筛查阳性率与TCT诊断结果比较,差异无统计学意义(P>0.05);传统琼脂包埋法的符合率较低,与另外两种琼脂包埋法比较,差异有统计学意义(P<0.05);琼脂温箱包埋法与琼脂冷冻包埋法诊断符合率较高,两者比较,差异无统计学意义(P>0.05);琼脂冷冻包埋法细胞更集中、平铺,制作简便。结论宫颈细胞蜡块制备可以辅助宫颈病变早期分流,琼脂冷冻包埋法是一种较好的宫颈细胞制备方法。

Objective To compare the effects of three different methods of making cell wax blocks in the screening of cervical lesions,to explore better methods of making cervical cell wax blocks,to improve the diagnostic accuracy,and to allow patients to get a reasonable shunt in the early screening.Methods 270 remaining samples of gynecological cervical liquid-based cytology(TCT)were collected from Liuzhou Workers Hospital from January to December 2018,including inflammation,low-grade squamous intraepithelial lesion(LSIL),and high-grade squamous intraepithelial lesion(HSIL),squamous cell carcinoma(SCC)cases,148 cases,35 cases,72 cases,and 15 cases respectively.The same sample was divided into 3 parts,and the cell wax block was prepared by the traditional agar embedding method,agar incubator coagulation embedding method,and agar freezing coagulation embedding method.Compare the film production effects,diagnostic positive rate and diagnostic coincidence rate of the three methods.Results There was no statistically significant difference in the positive rate of three cell wax preparation methods for screening high-grade lesions and above with the TCT diagnosis results(P>0.05);The coincidence rate of the traditional agar embedding method was relatively low.Compared with the other two agar embedding methods,the difference was statistically significant(P<0.05);The diagnostic coincidence rate between agar incubator embedding method and agar freezing embedding method was higher,and the difference between the two was not statistically significant(P>0.05);The agar freezing embedding method was more concentrated,flat,and easy to make.Conclusion The preparation of cervical cell wax block can assist in the early shunting of cervical lesions.Agar freezing embedding method is a better method for preparing cervical cells.