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背景与目的:食管拉网细胞学作为高发区无症状人群食管癌筛查的检查方法已经开展了数十年,但是拉网细胞学由于敏感性较低而限制了它自身的发展。本研究旨在在食管拉网细胞学中引入液基细胞学,探讨液基细胞学在我国食管癌拉网细胞学筛查中的应用价值。方法:对河南省林州市姚村镇的无症状居民进行拉网细胞学检查,受检者同时进行食管拉网液基细胞学TBS分级诊断和食道镜活检。以食道镜活检组织学诊断结果为标准,评估液基细胞学的敏感性和特异性。结果:在710例受检者中,食道镜活检组织学诊断原位癌及其以上病例17例(2.4%)。以细胞学非典型鳞状细胞或非典型腺细胞(ASC/AGC)及其以上诊断为阳性,液基细胞学诊断的敏感性和特异性分别为76.5%和76.0%。结论:在传统细胞学发展水平较高的医疗单位,液基制片技术对食管癌诊断的敏感性的提高作用并不明显,但可显著降低阅片人员的工作负荷。
BACKGROUND & OBJECTIVE: Esophageal net cytology as a screening method for esophageal cancer screening in asymptomatic populations of high incidence areas has been under way for decades, but pull-net cytology has limited its own development due to its low sensitivity. The purpose of this study is to introduce liquid-based cytology in esophageal nets cytology to explore the value of liquid-based cytology in the screening of esophageal neoplastic cytology in our country. Methods: Asymptomatic inhabitants of Yaocun Town in Linzhou City of Henan Province were examined by pull cytometry. The subjects underwent esophageal TBS grading diagnosis and esophageal biopsy simultaneously. Based on the results of histopathological diagnosis of esophageal biopsies, the sensitivity and specificity of liquid-based cytology were evaluated. RESULTS: Of the 710 subjects, histopathological diagnosis of carcinoma in situ and 17 of the above cases (2.4%) were detected by biopsy. Sensitivities and specificities of liquid-based cytology diagnoses were 76.5% and 76.0%, respectively, with a positive diagnosis of atypical atypical squamous cells or atypical glandular cells (ASC / AGC). Conclusion: In medical units with high level of traditional cytology, the enhancement effect of liquid-based imaging on the sensitivity of esophageal cancer diagnosis is not obvious, but it can significantly reduce the working load of reading workers.