液基细胞学联合阴道镜检测宫颈病变的临床研究  

Clinical study of cervical lesions detected by liquid-based pap test (LPT) and vaginoscopy

作　　者：苗凤英[1] 胡玉莲[1] 栾艳[1] 陈建梅[1] 

机构地区：[1]山东省日照市人民医院妇科,276800

出　　处：《中国妇幼保健》2007年第1期83-85,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨LPT液基细胞学与阴道镜联合在宫颈病变中检查的准确性。方法:对1644例受检者做宫颈脱落细胞液基标本采集,细胞学阳性者在阴道镜下活检可疑病灶病理检查。同时见到细胞核周空穴诊断和肿瘤相关人乳头瘤病毒(hu-manpapillomalius,HPV)检测。细胞学诊断采用TBS分级系统,即正常范围、阳性诊断包括意义不明的不典型鳞状细胞(AS-CUS)以上病变;诊断结果与阴道镜下活检病理检查诊断对照。结果:LPT液基细胞学共检出阳性涂片228例,占13·85%;其中不典型鳞状上皮细胞(ASCUS)105例,占6·38%;鳞状上皮内低度病变(LSIL)79例,占4·80%;鳞状上皮内高度病变(HSIL)34例,占2·06%;宫颈鳞状细胞癌(SCC)2例,占0·12%;类似湿疣感染者8例,占0·49%。总阳性检出率为15·98%。与阴道镜下活组织病理检查诊断符合率分别为LSIL79·79%(79/99),HSIL(CINⅡ15/18、CINⅢ19/19)占91·89%。SCC100%(2/2)HPV61·53%(8/13)。结论:LPT液基细胞学检查联合阴道镜下病理检查宫颈病变敏感性高,准确度强,尤其对HSIL诊断率高,有利于提高宫颈癌及癌前病变的早期诊断。Objective： To investigate the accuracy of cervical lesions detected by liquid -based pap test and vaginoscopy. Methods： 1644 cases with positive LPT received biopsy for the suspected lesion through vagionoseopy. Koilocytosis and human papilloma virus were detected. TBS classification was used for cytological diagnosis. The diagnostic results of LPT was compared with that of bioptic pathology. Results： 228 cases were detected with positive LPT （ 13.85% ）, 105 cases with ASCUS （6. 38% ）, 79 cases with LSIL （4. 80% ）, 34 cases with HSIL （2. 06% ）, 2 cases with SCC （0. 12% ） and 8 cases with similar warts （0. 49% ） respectively. The total positive rate was 15.98%. Combined with bioptic pathology, the diagnostic accuracy rate were LSIL 79. 79% （79/99）, HSIL （ CIN Ⅱ 15/18, CIN Ⅲ19/19） 91.89%, SCC 100% （2/2）, HPV 61.53% （8/13） . Conclusion： LPT and vaglnoscopy has a high sensitivity, a strong accuracy rate and high diagnostic rate especially to HSIL. This method improved the early diagnosis for cervical carcinoma and pathological changes before cervical carcinoma.

关 键 词：液基细胞学 阴道镜 宫颈病变 

分 类 号：R711.74[医药卫生—妇产科学]