宫颈液基细胞学技术的临床应用

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目的:探讨宫颈液基细胞学技术(TCT)在宫颈病变及宫颈癌筛查中的应用价值。方法:收集平阳县人民医院2010年10月1日至2011年3月30日964例妇科门诊患者、住院患者及体检人群的宫颈细胞学标本,所有标本均行TCT技术检查和传统宫颈巴氏涂片检查,采用TBS分类法对细胞学检查结果进行诊断,比较两种方法的细胞学异常检出率。对TCT结果诊断为ASCUS以上者,进行电子阴道镜检查及病理活检,对照分析TCT检查结果与活检病理结果。结果:TCT检查结果异常者78例,检出率为8.09%,传统宫颈巴氏涂片检查结果异常67例,检出率为6.95%,差异有统计学意义(P<0.05)。78例TCT检查异常者中,ASCUS 38例,LSIL 27例,HSIL 11例,SCC 2例。阴道镜检查及病理活检结果显示,78例ASCUS以上者中炎症32例,CIN I级30例,CIN II级9例,CINIII级5例,宫颈鳞癌2例。TCT检查结果与阴道镜检查及病理活检结果比较,异常人数符合率100.0%,LSIL符合率85.18%,HSIL符合率90.91%。结论:宫颈液基细胞学技术(TCT)可明显提高异常细胞的检出率,操作简单、方便,与阴道镜检查及病理活检的符合度高,对妇女宫颈病变及宫颈癌的筛查有重要的应用价值。 Objective: To investigate the value of cervical liquid-based cytology (TCT) in cervical lesions and cervical cancer screening. Methods: The cervical cytology specimens from 964 gynecological outpatients, inpatients and physical examination population of Pingyang People’s Hospital from October 1, 2010 to March 30, 2011 were collected. All samples were examined by TCT and conventional cervical Pap smear Check the film, the use of TBS classification cytology test results to diagnose, comparing the two methods of cytology detection rate. The results of TCT diagnosis of ASCUS or more, the electronic colposcopy and pathological biopsy, control analysis of TCT results and biopsy results. Results: There were 78 cases with abnormal TCT results, the detection rate was 8.09%. There were 67 cases with abnormal pap smear results, the detection rate was 6.95%, the difference was statistically significant (P <0.05). Of 78 TCT abnormalities, 38 were ASCUS, 27 were LSIL, 11 were HSIL and 2 were SCC. Colposcopy and biopsy results showed that in 78 ASCUS patients, there were 32 cases of inflammation, 30 cases of CIN I, 9 cases of CIN II, 5 cases of CINIII and 2 cases of cervical squamous cell carcinoma. The results of TCT were compared with those of colposcopy and biopsy. The coincidence rate of abnormal number was 100.0%, the coincidence rate of LSIL was 85.18% and the coincidence rate of HSIL was 90.91%. Conclusion: Cervical liquid-based cytology (TCT) can significantly improve the detection rate of abnormal cells. It is simple and convenient to operate, has high coincidence with colposcopy and pathological biopsy, and is important for screening of cervical lesions and cervical cancer in women The application value.
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