液基细胞学在宫颈病变筛查中的临床价值  

Clinical value of liquid-based cytology in screening of cervical lesions

作　　者：张庆华[1] 沈健[1] 胡婷[2] 杨茹[2] 李雄[2] 黄科程[2] 贾瑶[2] 王少帅[2] 陈枝岚[2] 袁静萍[3] 黄磊[1] 田训[1] 周航[2] 唐方徐[2] 李双[2] 

机构地区：[1]武汉市中心医院妇产科 [2]华中科技大学同济医学院附属同济医院肿瘤生物研究中心,湖北武汉430030 [3]武汉市中心医院病理科

出　　处：《中国妇幼保健》2012年第3期444-446,共3页Maternal and Child Health Care of China

基　　金：国家重点基础发展计划(973)资助项目〔2002CB513100〕;国家自然科学基金资助项目〔81101964〕

摘　　要：目的:评价液基细胞学(thinprep cytologic test,TCT)在宫颈病变筛查中的准确性。方法:回顾性分析武汉市中心医院2008年7月～2010年5月宫颈TCT筛查与宫颈活检结果603例。结果:30～49岁年龄段患者381例(63.18%),细胞学结果在正常、LSIL、HSIL中与组织学结果符合率分别为90.76%、11.54%、60.00%,TCT诊断准确性为88.89%,敏感性为66.00%,特异性为95.43%。不典型上皮内瘤变(atypical squamous cells,ASC)378例对应组织学结果分别为正常285例,宫颈上皮内瘤变(cervical intraepithelialneoplasia,CIN)Ⅰ25例,CINⅡ～Ⅲ65例,宫颈鳞状上皮细胞癌(squamous cellcarcinoma,SCC)3例。P16与Ki-67阳性率在组织学结果为正常或炎症,CINⅠ与CINⅡ～Ⅲ分别为50.00%,60.00%,100.00%和67.00%,80.00%,100.00%。结论:TCT是一种准确性高的筛查方法,对临床医生分析宫颈病变有指导意义。Objective：To evaluate the accuracy of thinprep cytological test（TCT） in screening of cervical lesions. Methods：The results of cervical screening with TCT and cervical biopsy of 603 cases in Central Hospital of Wuhan city from July 2008 to May 2010 were analyzed retrospectively. Results：The ages of 381 cases（63.18%） were 30-49 years,the coincidence rates of normal cervical tissue,low-grade squamous intraepithelial lesion（LSIL）,and high-grade squamous intraepithelial lesion（HSIL） between cytological results and histological results were 90.76%,11.54%,and 60.00%,respectively;the accuracy,sensitivity,and specificity of TCT were 88.89%,66.00%,and 95.43%,respectively.Among 378 cases with atypical intraepithelial neoplasia,285 cases were found with normal results,25 cases were found with cervical intraepithelial neoplasia（CIN） I,65 cases were found with CIN Ⅱ-Ⅲ,and 3 cases were found with squamous cell carcinoma by histological test.The positive rates of P16 and Ki-67 in the cases whose histological results were normal cervical tissue or inflammation,CIN I,and CIN Ⅱ-Ⅲ were 50.00%,60.00%,100.00% and 67.00%,80.00%,100.00%,respectively. Conclusion：TCT is a screening method with high accuracy,which has an instructional significance for clinicians to analyze cervical lesions.

关 键 词：液基细胞学 宫颈上皮内瘤变 宫颈筛查 病理组织学 

分 类 号：R737.33[医药卫生—肿瘤]