TCT与病理活检对早期宫颈癌及宫颈上皮内病变的诊断价值体会

Effect and value of TCT and pathological biopsy on early-stage cervical cancer and cervical intraendothelial lesions

目的分析早期宫颈癌及宫颈上皮内病变接受薄层液基细胞学检查(TCT)与病理活检的诊断价值。方法120例疑似早期宫颈癌及宫颈上皮内病变患者,均进行TCT和病理活检,以手术病理检查结果为金标准,分析两种检查方法的诊断结果。结果手术病理检查结果显示:正常或炎症59例,宫颈上皮内瘤变(CIN)Ⅰ级27例,CINⅡ级25例,CINⅢ级8例,鳞状上皮细胞癌抗原(SCC)1例。TCT结果显示:正常或炎症51例,低度鳞状上皮内病变(LSIL)38例,高度鳞状上皮内病变(HSIL)30例,SCC 1例。病理活检结果显示:正常或炎症54例,CINⅠ级31例,CINⅡ级25例,CINⅢ级9例,SCC 1例。TCT诊断准确度为70.83%(85/120),其中正常或炎症为67.80%(40/59),LSIL为62.96%(17/27),HSIL为81.82%(27/33),SCC为100.00%(1/1)。病理活检诊断准确度为89.17%(107/120),其中正常或炎症为88.14%(52/59),CINⅠ级为85.19%(23/27),CINⅡ级为92.00%(23/25),CINⅢ级为100.00%(8/8),SCC为100.00%(1/1)。病理活检的诊断准确度高于TCT,差异具有统计学意义(P<0.05)。结论早期宫颈癌及宫颈上皮内病变接受病理活检的检查准确度较TCT具有明显优势,临床中可根据情况选择联合诊断以提升准确度,在疾病早期准确诊断,并给予及时且有效的干预,可控制疾病发展并改善预后,临床价值显著。

Objective To analyze the diagnostic value of thin-cytologic test(TCT)and pathological biopsy on early-stage cervical cancer and cervical intraendothelial lesions.Methods All 120 patients suspected of early-stage cervical cancer and cervical intraepithelial lesions underwent TCT and pathological biopsy.The results of the two methods were analyzed based on the results of surgical pathology as the gold standard.Results The results of surgical pathology showed that 59 cases were normal or inflammatory,27 cases were cervical intraepithelial neoplasia(CIN)gradeⅠ,25 cases were CIN gradeⅡ,8 cases were CIN gradeⅢ,and 1 case was squamous cell carcinoma(SCC).TCT results showed that 51 cases were normal or inflammatory,38 cases were low-grade squamous intraepithelial lesion(LSIL),30 cases were high-grade squamous intraepithelial lesion(HSIL),and 1 case was SCC.Pathological biopsy results showed that 54 cases were normal or inflammatory,31 cases were CIN gradeⅠ,25 cases were CIN gradeⅡ,9 cases were CIN gradeⅢ,and 1 case was SCC.The diagnostic accuracy of TCT was 70.83%(85/120),of which 67.80%(40/59)was normal or inflammatory,62.96%(17/27)was LSIL,81.82%(27/33)was HSIL,and 100.00%(1/1)was SCC.The diagnostic accuracy of pathological biopsy was 89.17%(107/120),of which 88.14%(52/59)was normal or inflammatory,85.19%(23/27)was CIN gradeⅠ,92.00%(23/25)was CIN gradeⅡ,100.00%(8/8)was CIN gradeⅢ,and 100.00%(1/1)was SCC.The diagnostic accuracy of pathological biopsy was higher than that of TCT,and the difference was statistically significant(P<0.05).Conclusion For early-stage cervical cancer and cervical intraepithelial lesions,pathological biopsy has obvious advantage in diagnostic accuracy over TCT.In clinical practice,combined diagnosis can be selected according to the situation to improve the accuracy,and it is of great clinical value to accurately diagnose the disease in the early stage and give timely and effective intervention to control the disease and improve the prognosis.