酸性磷酸酶染色在宫颈癌筛查(非典型鳞状细胞)中的作用和临床意义

The Role and Clinical Significance of Acid Phosphatase Staining in Cervical Cancer Screening (Atypical Squamous Cell)

目的:分析酸性磷酸酶染色在宫颈癌(CC)筛查(非典型鳞状细胞)中的作用和临床意义。方法:选择2017年1月-2021年12月在吉林省妇幼保健院宫颈癌筛查时液基细胞学诊断为非典型鳞状细胞(ASC)(ASC-US或ASC-H)的134例患者,采用酸性磷酸酶染色对患者宫颈脱落细胞进行染色筛查,并与组织病理学诊断结果做对比,观察两种方式的阳性检出率及酸性磷酸酶染色的细胞学特征。结果:酸性磷酸酶染色的阳性检出率与组织病理学诊断结果对比,差异无统计学意义(P>0.05)。酸性磷酸酶染色的诊断准确度为98.51%,且酸性磷酸酶染色检测的特异度98.41%,敏感度98.59%。酸性磷酸酶染色的细胞学特征主要表现为中、表层细胞的核增大,底层细胞表现为不成熟化生或不典型化生,少部分细胞伴有与萎缩有关的退变及因异常细胞稀少或结构不清影响诊断。结论:使用酸性磷酸酶染色法检测非典型鳞状细胞的特异度、敏感度较高,在CC早期诊断中具有指导意义,值得进一步推广。

Objective:To analyze the role and clinical significance of acid phosphatase staining in cervical cancer (CC) screening (atypical squamous cells).Method:A total of 134 patients with atypical squamous cells (ASC) (ASC-US or ASC-H) diagnosed by Liguid-based cytology during cervical cancer screening in Jilin Provincial Maternal and Child Health Hospital from January 2017 to December 2021 were selected.The cervical exfoliated cells of patients were screened by acid phosphatase staining and compared with the results of histopathological diagnosis.The positive rate of the two methods and the cytological characteristics of acid phosphatase staining were observed.Result:There was no significant difference between the positive rate of acid phosphatase staining and histopathological diagnosis (P>0.05).The diagnostic accuracy of acid phosphatase staining was 98.51%,the specificity of acid phosphatase staining was 98.41%,and the sensitivity was 98.59%.The cytological characteristics of acid phosphatase staining mainly showed that the nucleus of middle and surface cells was enlarged,the atypical squamous cells in the bottom layer showed immature metaplasia or atypical metaplasia;a small number of atypical squamous cells are associated with atrophy related degeneration,and the diagnosis is affected by rare abnormal cells or unclear structure.Conclusion:The specificity and sensitivity of using acid phosphatase staining to detect atypical squamous cells are high,which has guiding significance in the early diagnosis of CC and is worthy of further promotion.