新柏氏薄层液基宫颈细胞涂片1600例临床分析  

Clinical Analysis of Liquid-based Cervical Smears Report of 1600 Cases

作　　者：金花 满德日娃 王新颖 段仙芝[2] 

机构地区：[1]内蒙古乌审旗妇幼保健所,内蒙古达布察尔017300 [2]北京市同仁医院妇产科,北京100730

出　　处：《内蒙古医学杂志》2009年第12期1427-1429,共3页Inner Mongolia Medical Journal

基　　金：中央财政补助地方公共专项资金子宫颈癌早诊早治项目

摘　　要：目的：分析妇女宫颈疾病患病情况和年龄分布,探讨TBS细胞学诊断宫颈上皮内病变的处理方法。方法：2007年7月2009年6月对1 600例妇科门诊患者行液基膜式薄层细胞学技术（Thin Prep cyto-logical test,TCT）检查,采用TBS诊断分类,结果按不同年龄分4个组进行观察和对照,对107例上皮异常者进行阴道镜检查和LEEP活检做病理诊断对照,随访318个月。结果：宫颈上皮内病变患病率≤20岁组最高（33.33%）,明显高于其他3个年龄组（9.76%,7.23%,7.41%）,差异有统计学意义（P〈0.01）;细胞学随访转阴性者：性质未定的不典型鳞状细胞（ASCUS）占84.47%（136/161）,低度鳞状上皮内病变（LSIL）占85.00%（17/20）;高度鳞状上皮内病变（HSIL）占57.14%（4/7）。结论：宫颈疾病患病年龄趋向年轻化;TCT技术对性质未定的不典型腺细胞（ASCUS）检出率仍低;不典型上皮细胞根据个体情况观察36个月或阴道镜下活检,LSIL应进行阴道镜检查,必要时镜下指导病理组织活检以诊断和治疗,HSIL必须治疗并以手术为主。Objective：To investigate the management of women with cervical cytological abnormalities following the Bethesda system and to study the morbidity and age distribution of women with cervical diseases.Methods： From August 2007 to June 2009,1600 case of the gynecological out-patients underwent Pap smears test.The cytological preparations were analyzed by a liquid-based technique such as TCT（Thinprep cytology test）and Bethesda（TBS-NCI） diagnostic criteria.The patients were divided into 4 groups accordding to different ages.One hundred and seven patients with epithelial cell abnormalities recivied colposcopy examination and cervical biopsy by LEEP（loop electrossurgical excision procedure） to futher make the pathologic diagnosis,and they were followed up for 3～8 months.Results： Most epithelial abnormalities was found in the age group of less than 20 years old（33.33%）,obviously higher than those of other 3 age groups（9.76%,7.23%,7.41%）,（P〈0.01）.The follow-up by cytological test of 3～18 months showed some of the patients turned normal,in which ASCUS（atypical squanmous cells of uncertain significance） was 84.47%（136/161）,LSIL（low-grade squarmous intraepithelial lesions） was 85.0%（17/20）,and HSIL（high-grade squarmous intraepithelial lesions）was 57.14%（4/7）.Conclusion： The onset of cervical diseases tendss to be in yonug women.Most patients with diagnosis of epithelial cell abnormalities and higher-grade lesions were at the age of 20～39.The Thinprep test dose not improve the diagnosis of AGUS（atypical glandular cell of uncertain significance）.Women with ASC（atypical squamous cell） should receive 3～6 montths,observation individually,or colposcopy examination including cervical biopsy.Diagnosis of LISL should be confirmed by colposcopy and when necessory,histopathological assessment is needed to direct the diagnosis and treatment.HSIL must be treated,mainly by operation.

关 键 词：宫颈癌前期病变 新柏氏薄层液基细胞学技术 细胞学检查 

分 类 号：R734.2[医药卫生—肿瘤]