Thinprep液基细胞学检查在子宫颈病变诊断中的应用研究  

Application Study of Thinprep Liquid Based Cytology Test in the Detection of Cervical Diseases

作　　者：米贤军[1] 白宝敏[2] 刘勇[2] 熊小英[2] 万波[2] 彭学呜[2] 钟守军[1] 黄兆华[1] 

机构地区：[1]广东省中山市博爱医院病理科,广东中山528401 [2]广东省中山市博爱医院妇产科

出　　处：《中国医师杂志》2005年第4期493-495,共3页Journal of Chinese Physician

基　　金：广东省中山市科委科研课题基金项目(2003A082)

摘　　要：目的评价Thinprep液基细胞学检测技术(简称TCT)及TBS系统在宫颈病变诊断中的应用价值。方法对11000例受检者的宫颈细胞采用TCT技术检测和TBS分类诊断,将诊断意义不明的不典型鳞状细胞(ASCUS)以上病变均列为细胞阳性病例,并进行阴道镜下多点取材活检,以病理学结果为金标准,将细胞学结果与活检结果作对照分析。结果TCT法标本满意率为96.36%,细胞阳性病例1206例,总检出率10.96%(1206/11000):其中癌(CA)15例(占0.14%,);高度鳞状上皮内病变(HSIL)89例(占0.81%);低度鳞状上皮内病变(LSIL)449例(4.08%);不除外高度鳞状上皮内病变的不典型鳞状细胞(ASC-H)73例(占0.66%);ASC-US+AGUS共580例(占5.27%)。对其中1128例进行病理检查:宫颈癌和癌前病变的病理阳性率和准确率分别是CA(100%,100%);HSIL(100%,91.01%);LSIL(67.12%,57.82%);ASC-H(54.17%,27.78%);ASC-US+AGUS病理阳性率是14.09%。结论TCT技术和TBS系统能准确、全面地反映宫颈癌和癌前病变,以及细菌、病毒、其它病原体的感染情况,是目前一种高效的宫颈癌筛查的一种手段。Objective To assess the value of thinprep liquid based cytology test (TCT) and Besthesda system (TBS) in diagnosis of cervial lesions. Methods 11000 cases of cervical lesions were detected with TCT and TBS.The samples of atypical squamous cells(ASC) and more severe than ASC lesions were classified into postive cytology,and then cytological results were compared with pathological examination results of cervical biopsies.Results The satisfactory rate of TCT samples was 96.36%, and the postive rate of abnormal epithelial cells diagnosed by TCT was 10.96%(1206/11000). Among 1206 cases, 15 cases(0.14%) of CA, 89 cases (0.81%) of HSIL, 449 cases (4.08%) of LSIL, 73 cases (0.66%) of ASC-H and 580 cases (5.27%) of ASC-US and AGUS. 1128 cases with postive cytologic results received pathological examination. The pathological positive rate of CA, HSIL, LSIL, ASC-H, and ASC-US and AGUS were 100%, 100%, 67.12%, 54.17% and 14.09%, respectively. The coincident rate of two examination methods was 100% for CA, 91.1% for HSIL,57.82% for LSIL and 27.78% for ASC-H. Conclusion TCT and TBS can accurately detect cervical cancer, precancerous lesions and infection of bacteria, virus and other pathogens, and at present is a means of screening cervical cancer.

关 键 词：THINPREP 病变诊断 液基细胞学检查 子宫颈 低度鳞状上皮内病变 细胞学检测技术 TBS系统 阳性病例 鳞状细胞 癌前病变 ASC 应用价值 分类诊断 技术检测 宫颈细胞 诊断意义 对照分析 TCT法 总检出率 病理检查 CT技术 感染情况 

分 类 号：R711.74[医药卫生—妇产科学]