快速石蜡切片病理检查在宫颈癌筛查异常者诊断中的应用价值

The Value of Rapid Paraffin Section Pathologic Examination in the Diagnosis of Cervical Cancer Screening Abnormalities

目的:探究快速石蜡切片病理检查在宫颈癌筛查异常者诊断中的应用价值。方法:选取2019年3月—2021年12月山东省成武县人民医院收治的136例宫颈癌筛查异常者,高危型HPV (HR-HPV)阳性且宫颈细胞学检查异常,按照随机数表法1∶1配对原则分为快速石蜡切片组68例和常规石蜡切片组68例。快速石蜡切片组患者进行快速石蜡切片病理检查,常规石蜡切片组患者进行常规方式制做石蜡切片。以术后病理检查为金标准,对比两组患者制片效率、病理检查结果、诊断准确率及组织学检出情况。结果:快速石蜡切片组固定操作、第1次浸蜡操作、透明胶水操作、第2次浸蜡操作、切片制作、获取病理报告时间短于常规石蜡切片组,差异有统计学意义(t=67.408、65.771、70.571、53.056、121.438、218.619,P<0.05);快速石蜡切片组病理检查显示,炎症14例、宫颈上皮内瘤变Ⅰ(CINⅠ)15例、CINⅡ17例、CINⅢ20例、宫颈癌2例;常规石蜡切片组病理检查显示炎症16例、CINⅠ14例、CINⅡ17例、CINⅢ18例、宫颈癌3例;两组患者不同病理检查方式诊断准确率对比,差异无统计学意义(χ^(2)=1.462,P>0.05)。快速石蜡切片组诊断Kappa指数高于常规石蜡切片组;两组患者不同病理检查方式对表面上皮-间质、性索组织间质、生殖细胞等检出率对比,差异无统计学意义(χ^(2)=0.119、0.056、0.376,P>0.05)。结论:快速石蜡切片病理检查应用于宫颈癌筛查异常者诊断制片效率较高,可缩短病理报告获取时间,诊断准确率及组织学检出率可靠。

Objective:To investigate the value of rapid paraffin section pathology in the diagnosis of those with abnormal cervi-cal cancer screening.Methods:A total of 136 cases of abnormal cervical cancer screening admitted to the hospital from March 2019 to December 2021,who were positive for high-risk HPV(HR-HPV)and had abnormal cervical cytology,were selected and divided into rapid paraffin section group of 68 cases and conventional paraffin section group of 68 cases according to the principle of randomized numerical table method with 1∶1 pairing.The rapid paraffin section group were subjected to rapid paraffin section pathologic examination,and the conventional paraffin section group were subjected to the conventional way of making paraffin sec-tions.Postoperative pathological examination was used as the gold standard and production efficiency,pathological findings,diag-nostic accuracy and histological detection were compared between the two groups.Results:The time for fixation operation,1st dip-ping wax operation,transparent glue operation,2nd dipping wax operation,section preparation,and obtaining the pathology report in the rapid paraffin section group was shorter than that in the conventional paraffin section group,and the difference was statisti-cally significant(t=67.408,65,771,70.571,53.056,121.438,218.619,P<0.05).Pathologic examination in the rapid paraffin sec-tion group showed inflammation in 14 cases,cervical intraepithelial neoplasia I(CINⅠ)in 15 cases,CINⅡin 17 cases,CINⅢin 20 cases,and cervical cancer in 2 cases.Pathologic examination in the routine paraffin section group showed 16 cases of inflam-mation,14 cases of CINⅠ,17 cases of CINⅡ,18 cases of CINⅢ,and 3 cases of cervical cancer.There was no statistically signifi-cant difference in the diagnostic accuracy rate of different pathological examination methods between the two groups of patients(χ^(2)=1.462,P>0.05).The diagnostic Kappa index of the rapid paraffin section group was higher than that of the conventional paraffin section group,and the difference in the detection rate of surface epithelium-mesenchyme,interstitium of sex cord tissue,germ cells and so on between different pathological examination modes in the two groups of patients was not statistically significant(χ^(2)=0.119,0.056,0.376,P>0.05).Conclusion:Rapid paraffin section pathology is applied to cervical cancer screening abnormalities with high diagnostic slice efficiency,which can shorten the time of obtaining the pathology report,with reliable diagnostic accuracy and histologic detection rate.