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

TCT and preoperative pathology on the diagnosis of early cervical carcinoma and cervical intraepithelial lesions

目的分析薄层液基细胞学检查(TCT)、病理活检在早期宫颈癌、宫颈上皮内病变中的实际诊断价值。方法选取2020年02月至2022年12月焦作市妇幼保健院收治的86例疑似宫颈癌及宫颈上皮内病变患者作为研究对象,纳入研究患者均接受TCT与术前病理活检,将二者实际诊断结果与“金标准”检查(术后病理活检)进行对照,对其诊断结果及阳性征象检出率进行分析比较。结果86例疑似患者经术后病理检查确诊宫颈癌14例、意义不明的非典型鳞状细胞35例、宫颈内上皮病变低级17例、宫颈内上皮病变高级14例,确诊6例。TCT检查确诊宫颈癌5例、意义不明的非典型鳞状细胞48例、宫颈内上皮病变低级7例、宫颈内上皮病变高级24例,未确诊2例;术前病理活检检查确诊宫颈癌14例、意义不明的非典型鳞状细胞34例、宫颈内上皮病变低级17例、宫颈内上皮病变高级14例,确诊7例,术前病理活检与“金标准”的符合率明显高于TCT,差异有统计学意义(P<0.05),术前病理活检与“金标准”仅在意义不明的非典型鳞状细胞中存在1例不符;TCT诊断准确度、灵敏度及特异度分别为91.86%、98.75%、50.00%,术前病理活检准确度、灵敏度及特异度分别为98.84%、98.75%、100.00%,两种检查准确度、特异度对比,差异有统计学意义(P<0.05)。结论对比TCT,术前病理活检能给予早期宫颈癌、宫颈上皮内病变较精确的诊断,值得应用。

Objective To study the clinical value of Thinprep Cytologic Test(TCT)and preoperative pathology on the diagnosis of early cervical carcinoma and cervical intraepithelial lesions.Methods 86 suspected patients checked from February 2020 to December 2022 were chosen as research samples.TCT and preoperative pathology were performed;the postoperative pathological biopsy results were seen as god standard.The diagnosis results and positive sign detection rates were compared.Results The postoperative pathological biopsy indicated 14 cervical carcinoma cases,35 atypical squamous cell,undetermined significant cases,17 low-grade cervical intraepithelial lesion cases,14 high-grade cervical intraepithelial lesion cases and 6 undetermined cases.TCT indicated 6 cervical carcinoma cases,45 atypical squamous cell,undetermined significant cases,6 lowgrade cervical intraepithelial lesion cases,10 high-grade cervical intraepithelial lesion cases and 25 undetermined cases.The preoperative pathology indicated 14 cervical carcinoma cases,34 atypical squamous cell,undetermined significant cases,17 low-grade cervical intraepithelial lesion cases,14 high-grade cervical intraepithelial lesion cases and 7 undetermined cases.The diagnosis accordance rates of preoperative pathology with gold standard were significantly higher than those based on TCT(P<0.05);just one case was unmatched based on the preoperative pathology and gold standard.The diagnosis accuracy,sensitivity and specificity based on TCT(91.86%,98.75%,50.00%)were found to be statistically significant from those based on the preoperative pathology(98.84%,98.75%,100.00%)(P<0.05).Conclusion Compared with TCT,the pathological biopsy has the higher diagnosis efficacy of early cervical carcinoma and cervical intraepithelial lesions.It is of great importance in clinical treatment.