宮頸液基細胞學質控分析

A quality analysis of liquid based cervical cytology

目的分析本院宮頸細胞學檢查結果的質量指標,藉此提高宮頸癌篩查工作的質量。方法收集2017年本科宮頸細胞學的ASC-US率、ASC-US/SIL比率作為診斷不確定度監測。收集2017年鏡湖醫院婦產科病人宮頸細胞學陽性病例,及其隨後6個月内進行宮頸活檢結果,計算陽性預測值。回顧2017年進行宮頸活檢病例,及其前30個月内的宮頸細胞學的結果,計算假陰性率。結果全院2017年全年的ASC-US的檢出率是4.24%(1358/32048)。宮頸細胞學的ASC-US/SIL比例為2.82:1。陽性預測值為83%,假陰性率為5.7%。結論各項指標均符合質控目標。細胞學與組織學對照的統計分析定期進行,對誤診漏診的原因及時反饋,藉此更有效地提升宮頸細胞學的質量。細胞學異常而需跟進的病例呈低應答率,應加強跟進,否則失去篩檢的意義。

Objective To analyze the quality indicators of the cervical cytological examination results in our hospital in order to improve the cervical cancer screening quality.Methods As an uncertain diagnostic ratio for an auditorium,ASC-US rate and ASC-US/SIL ratio of cervical cytology were collected from the Department in 2017.For positive predictive value,the cases with positive cervical cytology and their follow-up results of the cervical biopsy in 6 months duration were collected from the Obstetrics and Gynecology Department at Kiang Wu Hospital in 2017.For false negative rate,the cases underwent cervical biopsy and their cervical cytology results within the previous 30 months were reviewed in 2017�Results ASC-US rate was 4.24%(1358/32048).ASC-US/SIL ratio is 2.82:1.The positive predictive rate was 83%and the false negative rate was 5.7%.Conclusion All indicators meet the requirements of the quality control purpose.Statistical analysis of concordance of cytology and histology should be carried out routinely to provide timely feedback of the causes of misdiagnosis and missed diagnosis and to improve more effectively the quality of cervical cytology.Because the low response rate of the abnormality,a strengthen follow-up is suggestive,otherwise,it is meaningless of screening.