液基薄层细胞学技术在宫颈病变筛查中的应用  

Liquid-based Cytology Thinprep Cytologic Test in Screening of Intraepithelial Neoplasia

作　　者：刘玉玲[1] 郑巧荣[1] 王春萍[1] 张东亚[1] 白燕玲 

机构地区：[1]郑州大学第二附属医院,郑州市450003 [2]郑州客运段计划生育办公室,郑州市450000

出　　处：《医药论坛杂志》2004年第13期34-36,共3页Journal of Medical Forum

摘　　要：目的　评价液基薄层细胞学技术在宫颈病变筛查中的灵敏性。方法　对 1733例液基薄层细胞学检测 (TCT)结果与 2 2 2 9例传统巴氏涂片的检测结果进行对比分析。结果　传统巴氏涂片检测出Ⅲ级 9例 ,Ⅳ级 2例 ,Ⅴ级 1例 ,阳性率 0 .5 3% (12 / 2 2 2 9)。液基薄层细胞学检测出低度鳞状上皮内瘤变 (LSIL) 4 8例 ,高度鳞状上皮内瘤变 (HSIL) 14例 ,鳞癌 2例 ,总阳性率 3.7% (6 4 / 1733) ,明显高于传统巴氏涂片的阳性率 (P <0 .0 1)。并对 6 4例TCT检查异常者中的 4 5例进行了病理检查 ,LSIL 32例经病理检查诊断为炎症 2 3例 ,宫颈上皮内瘤 (CIN)Ⅰ级 6例 ,CINⅡ级 2例 ,原位癌 1例 ;HSIL 11例病理检查诊断为炎症 2例 ,CINⅢ级 5例 ,原位癌 4例 ;2例鳞癌均经病理检查证实。LSIL、HSIL、鳞癌与组织学检查的符合率分别为 18.7% (6 / 32 )、81.8%(9/ 11)、10 0 % (2 / 2 )。结论　TCT用于宫颈病变的筛查敏感性高 ,可克服传统巴氏涂片假阴性率高的弊端。Objective To evaluate the sensitivity of thinprep cytologic test( TCT) for cervical intraepithelial neoplasia screening. Methods The results of TCT from 1733 cases of the gynecological out-patients,as well as the results of conventional smear from 2229 cases of the similar patients were analyzed comparatively.Results All the cases were diagnosed by conventional smear,9 cases with Ⅲ grade,2 cases with Ⅳ grade and 1 case with Ⅴ grade.The positive rate was 0 53%(12/2229).As for the liquid-based cytology,All the cases were detected which included 48 cases of low grade squmamous intraepithelial lesion(LSIL),14 cases of high grade intraepithelial lesion(HSIL) and 2 cases of squamous cell carcinoma.The positive rate was 3 7%,(64/1733),which was significantly higher than that of conventional smear(P<0.01).In addition,45 cases of all the 64 cases with squamous intraepithelial lesion received pathologic examination.The results were as follow:among 32 cases with LSIL,23 cases were with inflammation,6 cases with CIN Ⅰ,2 cases with CINⅡ and 1 cases with carcinoma in site;among 11 cases with HSIL,2 cases were with inflammation,5 cases with CINⅢ and 4 cases with carcinoma in site;2 cases with squamous cell carcinoma were all confirmed by histologic examination.The coincidence rate of LSIL,HSIL and squmous cell carcinoma with pathologic examination was 18 7%(6/32),81 8%(9/11) and 100%(2/2) respectively.Conclusion TCT was a more sensitive method for screening of cervical intraepithelial neoplasia,which can overcome the shortcoming of high false negative rate of conventional smear.

关 键 词：液基细胞学 传统巴氏涂片 宫颈上皮内瘤样病变 

分 类 号：R73021[医药卫生—肿瘤]