液基薄层细胞学检测在老年人群宫颈癌前病变及宫颈癌筛查中的应用价值

Application value of liquid⁃based thin⁃layer cytology in screening cervical precancerous lesions and cervical cancer in an elderly population

目的:探究液基薄层细胞学(TCT)检测在老年人群宫颈癌前病变及宫颈癌筛查中的应用价值。方法:选取2015年12月—2020年12月间于黄石市妇幼保健院接受TCT检测的60岁以上宫颈癌前病变筛查体检者的临床资料进行回顾性分析,共80例,所有对象均按照2001年国际癌症协会制定的新Bethesda系统(TBS)标准进行宫颈癌前病变诊断与分类,以病理组织学检查结果为金标准,计算TCT检查对宫颈癌前病变诊断的敏感度、特异度、准确率、阴性预测值和阳性预测值。结果:80例TCT细胞学检查结果显示,病变分型符合率分别为低度鳞状上皮内病变75.00%(9/12),高度鳞状上皮内病变76.92%(30/39),宫颈癌100%(7/7),其中2例为宫颈上皮内瘤变(CIN)Ⅰ,1例为CINⅡ;15例非典型鳞状细胞(ASC-US)者经进一步组织病理检查,结果显示5例为炎症,2例为CINⅠ,4例为CINⅡ,4例为CINⅢ;以病理组织学为确诊金标准,58例为阳性,阳性率为72.50%,22例为阴性,阴性率为27.50%;TCT检查诊断标准,61例为阳性,阳性率为76.25%,19例为阴性,阴性率为23.75%。TCT检查结果显示,对60岁以上宫颈癌前病变诊断的敏感度、特异度、准确率、阳性预测值、阴性预测值分别为94.83%、72.73%、88.75%、90.16%、84.21%。结论:TCT检查有利于60岁以上宫颈癌前病变筛查诊断,可为临床治疗提供可靠依据。

Objective:To explore the application value of liquid‐based thin‐layer cytology(TCT)in screening cervical precancerous lesions and cervical cancer in an elderly population in Hubei,China.Methods:The clinical data of 80 cervical precancerous lesions screened and examined by TCT in Huangshi Maternity&Children′s Health Hospital from December 2015 to December 2020 were analyzed retrospectively.All patients were diagnosed and classified according to the new Bethesda system(TBS)standard modified by the International Cancer Society in 2001,with histopathological examination results adopted as the gold standard.To analyze the application value of TCT in screening cervical precancerous lesions and cervical cancer over 60 years old,the sensitivity,specificity,accuracy,negative predictive value,and positive predictive value of TCT were calculated.Results:The coincidence rate of pathological classification in TCT cytology was 75.00%(9/12)for low‐grade squamous intraepithelial lesions,76.92%(30/39)for high‐grade squamous intraepithelial lesions,and 100%(7/7)for cervical cancer,respectively.Of the 15 cases of the atypical squamous cell of undetermined significance(ASC‐US)screened out by TCT,the results of the pathological examination showed 5 cases of inflammation,2 cases of cervical intraepithelial neoplasia(CIN)Ⅰ,4 cases of CINⅡ,and 4 cases of CINⅢ.In this study,80 cases of cervical precancerous lesions over 60 years old were screened for physical examination.By pathological examination,the results showed that 58 cases were positive,the positive rate was 72.50%,and 22 cases were negative,the negative rate was 27.50%;by TCT examination,61 cases were positive,the positive rate was 76.25%,and 19 cases were negative,the negative rate was 23.75%.The results showed that the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of TCT in the diagnosis of cervical precancerous lesions over 60 years old were 94.83%,72.73%,88.75%,90.16%,and 84.21%,respectively.Conclusion:TCT examination is beneficial to the screening and diagnosis of cervical precancerous lesions over 60 years old and can provide a reliable basis for clinical treatment.