TCT联合TIS技术在中山市大规模宫颈癌筛查中的应用研究  

Research on application of TCT combined with TIS technology in large-scale cervical cancer screening in Zhongshan city

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

机构地区：[1]南方医科大学附属中山市博爱医院病理科,广东中山528400 [2]中国医学科学院北京协和医院妇产科 [3]中山大学肿瘤防治中心病理科

出　　处：《中国妇幼保健》2013年第6期916-919,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科研项目〔20113A004〕

摘　　要：目的:评价新柏氏液基薄层细胞学检测(TCT)联合新柏氏电脑辅助阅片系统(TIS)在大规模宫颈癌筛查中的应用价值。方法:对10 000例受检者的宫颈细胞经TCT技术制片,细胞病理学医师阅片两次,先采用新柏氏TCT人工阅片(TP)进行第1次细胞学诊断,在适当的间隔期后用TIS进行第2次诊断,并对两次细胞学结果进行比较分析。将ASCUS/AGC+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CIN1+病变列为病理学阳性病例,以病理学检查为金标准,将细胞学与病理活检结果作对照分析。结果:用TP每h能筛查13.8张片,而TIS能筛查29.8张片,工作效率提高了115.94%。在10 000例细胞涂片中,TP的细胞阳性病例568例,总检出率5.68%,其中LSIL 151例、HSIL 66例、CA 3例、ASC-H 57例、ASCUS 259例、AGC 32例。TIS的细胞阳性病例621例,总检出率6.21%,其中LSIL 162例、HSIL 85例、CA 3例、ASC-H 65例、ASCUS 273例、AGC 33例。TIS与TP阳性细胞学结果比较,TIS的阳性细胞、LSIL、HSIL、ASC-H、ASCUS检出率比TP分别提高了9.33%、7.28%、28.79%、14.04%、5.41%。对细胞阳性病例均行病理学检查并与细胞学结果比较,TP和TIS的病理学符合率分别为92.61%和93.40%。结论:TCT联合TIS技术能明显提高异常细胞的检出率和大大提高工作效率,它是一种高效、高质量和高准确率的宫颈癌筛查技术,特别适合于大规模宫颈癌筛查,有利于早期诊断宫颈癌和癌前病变。Objective： To evaluate the application value of Thinprep liquid -based cytology test （TCT） combined with computer- assisted ThinPrep imaging system （TIS） in large -scale cervical cancer screening. Methods： The cervical cells of 10 000 cases were pre- pared for TCT, then eytopathological doctors read the smears for two times, the first cytological diagnosis was obtained by manually reading ThinPrep thinlayer cytology （TP）, then the second diagnosis was obtained after appropriate interval by TIS; the cytological results were com- pared and analyzed. The cases with atypical squamous cells of undetermined significance （ASCUS） /atypical glandular cells （AGC） or a- bove lesions were designed as cytologically positive cases, colposcopic muhipoint biopsy was conducted; the cases with cervical intraepithelial neoplasia （CIN） I or above lesions were designed as pathologically positive cases. The resuhs of pathological examination were designed as gold standards; the cytological results and pathological results were compared and analyzed. Results： TP could screen 13.8 pieces of smears every hour, but TIS could screen 29. 8 pieces of smears every hour, the work efficacy was improved by 115.94%. Among l0 000 smears, 568 positive smears were detected by TP, the total detection rate was 5.68% , including 151 smears of low grade squamous intraepithelial le- sion （ LSIL）, 66 smears of high grade squamous intraepithelial lesion （ HSIL）, 3 smears of cervical cancer, 57 smears of atypical squamous cells -cannot exclude HSIL （ASC -H）, 259 smears of ASCUS, and 32 smears of AGC; 621 positive smears were detected by TIS, the total detection rate was 6. 21% , including 162 smears of LSIL, 85 smears of HSIL, 3 smears of cervical cancer, 65 smears of ASC - H, 273 smears of ASCUS, and 33 smears of AGC. The positive detection rates of LSIL, HSIL, ASC - H, and ASCUS detected by TIS were higher than those detected by TP, increasing by 9. 33%, 7. 28% , 28.79% , 14.04% , and 5.41% , respectively. The cas

关 键 词：新柏氏电脑辅助阅片系统 新柏氏液基薄层细胞学检测 宫颈癌 癌前病变 

分 类 号：R737.33[医药卫生—肿瘤]