TCT在宫颈病变筛查中的临床价值及不足  

Significance and weakness of thinprep cytology test in detecting of cervical lesions

作　　者：杨怡卓[1] 李亚里[1] 徐滨[1] 付玉荣[1] 李萍[1] 

机构地区：[1]中国人民解放军总医院妇产科,北京100853

出　　处：《中国妇产科临床杂志》2008年第2期87-89,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的通过与病理组织学比较,评价液基细胞学(TCT)在宫颈病变诊断中的临床价值与不足。方法选取2004年8月～2006年10月中国人民解放军总医院妇产科行液基细胞学检查的766例患者,在电子阴道镜下取宫颈活组织进行病理组织学检查。结果TCT与病理组织学的符合率在低度鳞状上皮内病变(LSIL)中为12.07%(21/174),高度鳞状上皮内病变(HSIL)符合率58.82%(50/85),宫颈癌符合率为70%(7/10)。在348例ASC中,14.94%(52/348)为CINⅡ～Ⅲ,1.44%(5/348)为宫颈癌,在35例AGC中,11.43%(4/35)为CINⅡ～Ⅲ,2.86%(1/35)为宫颈癌。宫颈癌发病年龄呈现双峰现象,分别为30～39岁和≥45岁。结论作为宫颈病变的初筛方法,TCT存在一定的假阳性和假阴性率,结合阴道镜下活检后,能明显提高诊断的准确率,做到早期发现,早期治疗。Objective To evaluate clinical significance and weakness of liquid based cytology test （TCT） in diagnosis of cervical lesions. Methods From August 2004 to October 2006, TCT reports of 766 women were compared with their colposcopy and multiple biopsies at the Department of Obstetrics and Gynecology, the General Hospital of PLA. Results The coincidence rates of TCT with pathologic histology were 12.07% （21/174） with LSIL, 58. 82% （50/85） with HSIL and 90% （7/10） with cervical cancer. Among 348 cases with ASC, 14. 94% （52/348） was with CIN Ⅱ-Ⅲ , 1.44% （5/348） was with cervical cancer diagnosed pathologically. Among the 35 cases with AGC, 11.43% （4/35） was with CIN Ⅱ-Ⅲ , 2.86% （1/35） with cervical cancer. In the cases of cervical cancer, the predilection ages of onset showed double hump, 30-39 years old and ≥45 years old. Conclusions As a preliminary screening method of cervical cancer, TCT may have false positive or negative results. But combined with colposcopy and multiple biopsy, TCT can improve the diagnostic accuracy of cervical lesions and be helpful in early diagnosis and early treatment.

关 键 词：宫颈病变 细胞学 TBS诊断 

分 类 号：R711.7[医药卫生—妇产科学]