TCT联合阴道镜检查在宫颈病变筛查中的临床应用  

Clinical Practice of ThinPrep Cytologic Test Combined with Colposcopy in Diagnosis of Cervical Lesions

作　　者：宋光耀[1] 邹娜[1] 王亚萍[1] 李广慧[1] 王伟[1] 

机构地区：[1]辽宁省大连市妇产医院病理科,辽宁大连116033

出　　处：《实用预防医学》2010年第4期710-712,共3页Practical Preventive Medicine

摘　　要：目的探讨薄层液基细胞学检测方法(ThinPrep cytologictest,TCT)联合阴道镜检查在宫颈病变筛查中的临床应用。方法统计5288例行TCT检查的患者细胞学结果,并对210例细胞学阳性者与组织学结果进行对照分析。结果5288例细胞学结果,满意率为99.0%,其中无上皮内病变或恶性病变4565例,鳞状细胞及腺细胞异常660例,重新采样53例。210例细胞学阳性中,鳞状细胞异常者组织学阳性率为62.25%(127/204)高于腺细胞33.33%(2/6),但差异无统计学意义(P>0.05)。LSIL、HSIL、SCC的诊断符合率分别为73.91%(17/23)、80.95%(34/42)、100%(1/1)。细胞学为ASC-H者组织学结果伴有CIN或HPV感染的百分率明显高于ASC-US(P<0.01)。结论TCT联合阴道镜检查对宫颈鳞状细胞病变的筛查优于腺细胞,临床医生应提高对不满意涂片、ASC-US、AGC及ASC-H的重视。Objective To study the clinical practice of ThinPrep cytologic test（TCT）combined with colposcopy in screening cervical lesions.Methods Cervical cytology screening was performed in 5,288 cases by TCT,and further biopsy under colposcopy was conducted on 210 positive cases.Results In 5,288 cases,99.0% of them were satisfactory,including 4,565 negative cases for intraepithelial lesion or malignancy,660 positive cases and 53 unsatisfied cases.In 210 positive cases,the positive rate of histology in squamous cells （62.25%,127/204） was higher than that in endocervical cells （33.33%,2/6）,but no statistically significant difference was found （P0.05）.The diagnostic accordance rate by TCT was 73.91%（17/23） for low-grade squamous intraepithelial lesion （LSIL）,80.95% （34/42） for high-grade squamous intraepithelial lesion （HSIL）,100%（1/1） for squamous cell carcinoma （SCC）,respectively.The positive rate of cervical intraepithelial neoplasia and/or HPV infection in ASC-H cases was higher than that in ASC-US cases （P0.01）.Conclusions TCT combined with colposcopy shows better clinical practice in diagnosis of squamous cell lesions than endocervical cells.Clinicians should give weight to unsatisfied smear,ASC-US,AGC as well as ASC-H.

关 键 词：液基细胞学检测技术 宫颈病变 阴道镜 

分 类 号：R711.74[医药卫生—妇产科学]