膜式液基超薄细胞学检测宫颈病变18889例分析  

Analysis of liquid-based cytological diagnosis in 18889 cases of cervical disease

作　　者：邱洁[1] 李法升[1] 邢娟[1] 

机构地区：[1]深圳市第二人民医院妇产科,广东省深圳518035

出　　处：《中国基层医药》2007年第6期898-899,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 评价液基细胞学对宫颈病变的诊断价值。方法 利用膜式液基超薄细胞学检测进行妇科门诊及体检中心宫颈病变筛查18889人次，对TBS分级系统细胞学阳性者进行阴道镜下活检对比。结果宫颈细胞学阳性1089例．阳性率为5．8％；阴道镜下活检384例（活检率为35．3％），细胞学不典型鳞状细胞（ASCUS）者活检33．0％为宫颈上皮内瘤变（CIN）．鳞状上皮内低度病变（LSIL）活检约59．0％为CIN，鳞状上皮内高度病变（HSIL）活检重度不典型增生、原位癌或浸润癌为31．6％；不同年龄组宫颈ASCUS病例的病理结果无明显差异。结论 液基超薄细胞学宫颈病变筛查的假阴性率低。对于细胞学阳性者及时阴道镜下活检明确诊断，并积极物理治疗或宫颈电环切除术等，尔后每年复查1次；对于细胞学阴性者每2～3年筛查1次，即可达到防治宫颈癌的目的。Objective To evaluate the liquid-based cytology in the diagnosis of cervical disease, and discuss prophylaxis and treatment methods of cervical carcinoma. Methods 18889 cases were detected using thinprep cytology test（TCT） in gynecologic clinic service and medical examination center, from which TBS（the bethesda system） positive cases were compared with colposcopical biopsy results. Results 1089 cases were TCT positive, the average rate was 5.8 % （1089/18889） ,384 of these 1089 cases were agreement with the colposcopical biopsy, the biopsy rate was 35.3% （384/1089）. In these 384 cases,221 cases were diagnosed as atypical squamous cell of undetermined significance（ASCUS）, 33.0 % （73/221 ） of ASCUS were diagnosed as cervical intraepithelial neoplasia （CIN） ; 61 cases were diagnosed as low grade squamous intraepithelial lesions（ LSIL）, 59 % （36/61） of LSIL were diagnosed as CIN; 89 cases were diagnosed as high grade squamous intraepithelial lesions（HSIL） ,31.6 % （28/89） of HSIL were diagnosed as CIN Ⅲ , carcinoma in situ（CIS） or infiltrating carcinoma. There was no significant difference between different age groups in the pathologic diagnosis of cervical ascus case. Conclusions TCT system can significantly reduce false positive ratio, decrease false positive rate in screening of cervical carcinoma, patients with cytological positive should be diagnosed affirmatively by colposcopical biopsy, and receive cervical physical treatment or loop excision, and then were follow up by TCT every year. Patients with negative cytological result should be taken TCT every 2-3 years,so that invasive cervical carcinoma is prevented.

关 键 词：细胞学技术 阴道镜检查 宫颈炎 宫颈肿瘤 宫颈上皮重度增生 宫颈糜烂 

分 类 号：R737[医药卫生—肿瘤] R711[医药卫生—临床医学]