Thinprep液基细胞学在中山市大规模宫颈癌筛查中的应用  

Application of Thinprep liquid based cytology in large-scale screening of cervical cancer in Zhongshan city

作　　者：王莹[1] 米贤军[1] 沈铿[2] 余艳红[3] 肖琳[1] 徐秀梅[1] 孪峰[1] 钟守军[1] 段立锋[1] 陈昂[1] 

机构地区：[1]南方医科大学附属中山市博爱医院妇科,广东中山528400 [2]中国医学科学院北京协和医院妇产科 [3]南方医科大学南方医院妇产科

出　　处：《中国妇幼保健》2012年第33期5256-5259,共4页Maternal and Child Health Care of China

基　　金：国家科技部"十一五"科技支撑重点项目-子课题〔2008BAI58B01〕;中山市科技计划项目重大专项〔20113A004〕

摘　　要：目的:评价Thinprep液基细胞学检测技术(TCT)在大规模宫颈癌筛查中的应用价值。方法:对44 936例受检者的宫颈细胞采用TCT技术检测和TBS分类诊断,将ASCUS/AGC以上病变列为细胞学阳性病例并进行阴道镜下多点取材活检,将CIN及以上病变列为组织病理学阳性病例,以病理学检查结果为"金标准",将细胞学结果与病理活检结果作对比分析。结果:44 936例涂片中,细胞阳性病例1 413例,总检出率3.14%,其中低度鳞状上皮内病变(LSIL)202例(0.45%),高度鳞状上皮内病变(HSIL)128例(占0.28%),鳞状细胞癌(SCC)4例(占0.09‰),腺癌(AC)1例(占0.02‰),不除外高度鳞状上皮内病变的不典型鳞状细胞(ASC-H)119例(占0.27%),意义不明的不典型鳞状细胞(ASCUS)919例(占2.05%),不典型腺细胞(AGC)40例(占0.09%)。对其中761例行病理学检查,并与细胞学结果比较,TCT的病理学阳性率分别为SCC 100.00%(4/4),AC100.00%(1/1),HSIL 90.40%(66/73),LSIL47.27%(52/110),ASC-H 67.69%(44/65),ASCUS16.32%(79/484),AGC 41.66%(10/24)。TCT的病理学准确率分别为SCC 100.00%(4/4),AC 100.00%(1/1),HSIL 60.01%(46/73),LSIL 37.20%(41/110)。结论:TCT检查是一种简便、高效的宫颈癌和癌前病变筛查方法,有利于早期诊断、早期治疗宫颈癌和癌前病变。Objective：To evaluate the application value of Thinprep liquid based cytologic test（TCT） in large-scale screening of cervical cancer.Methods：The cervical cells of 44 936 cases were detected by TCT,then TBS classification was performed;the cases with cervical lesions above atypical squamous cells of undetermined significance（ASCUS）/atypical glandular cells（AGC） were designed as cytological positive cases,and colposcopic multiple punch biopsy was conducted,the cases with cervical intraepithelial neoplasia（CIN） or above CIN lesions were designed as histopathological positive cases,the pathological results were designed as gold standards,then the cytological results were compared with pathological results after biopsy.Results：Among 44 936 cases,1 413 cases were diagnosed as cytological positive cases,the total detection rate was 3.14%,including 202 cases with LSIL（0.45%）,128 cases with HSIL（0.28%）,4 cases with squamous cell carcinoma（SCC）（0.09‰）,one case with AC（0.02‰）,119 cases with ASC-H（0.27%）,919 cases with ASCUS（2.05%）,and 40 cases with AGC（0.09%）.A total of 761 cases underwent pathological examination,then the results were compared with cytological results,the pathological positive rates of ACC,AC,HSIL,LSIL,ASC-H,ASCUS,and AGS detected by TCT were 100.00%（4/4）,100.00%（1/1）,90.40%（66/73）,47.27%（52/110）,67.69%（44/65）,16.32%（79/484）,and 41.66%（10/24）,respectively.The pathological accurate rates of SCC,AC,HSIL,and LSIL detected by TCT were 100.00%（4/4）,100.00%（1/1）,60.01%（46/73）,and 37.20%（41/110）,respectively.Conclusion：TCT is a convenient and power-efficient screening method for cervical cancer and cervical precancerous lesion,which is useful for early diagnosis and early treatment of cervical cancer and cervical precancerous lesion.

关 键 词：液基薄层细胞学检测 TBS系统 宫颈癌 癌前病变 病理学检查 

分 类 号：R737.33[医药卫生—肿瘤]