宫颈癌前病变患者在新柏氏液基细胞学检测诊断中出现假阴性的相关因素分析  

Relative factors analysis of false-negative in thinprep cytolog test of patients with cervical intraepithelial neoplasia

作　　者：孙培勇 SUN Peiyong(Cell Room,Pathological Diagnosis Center,Hu′nan Cancer Hospital,Hu′nan Province,Changsha410013,China)

机构地区：[1]湖南省肿瘤医院病理诊断中心细胞室,湖南长沙410013

出　　处：《中国当代医药》2022年第23期145-148,152,共5页China Modern Medicine

摘　　要：目的分析宫颈癌前病变(CIN)患者在新柏氏液基细胞学检测(TCT)诊断中出现假阴性的相关因素。方法回顾性分析2019年4月至2021年5月湖南省肿瘤医院病理诊断中心的96例行TCT检测的CIN患者的细胞学检测结果,根据所得结果将阴性即未见上皮内病变或恶性病变(NILM)视为细胞学假阴性,并将细胞学假阴性患者作为观察组,细胞学异常患者作为对照组。同时统计两组患者的年龄、病变位点等相关临床资料,将单因素分析有统计学差异的资料行logistic多因素分析,并根据相关因素提出针对性的有效的防护措施。结果96例CIN患者中,TCT诊断假阴性12例,假阴性率为12.50%;观察组和对照组的年龄≥30岁、宫颈单点病变、病灶与宫颈管距离≥1 cm、细胞量<40%、宫颈重度炎症、有细胞学医生漏诊、有腺细胞或化生细胞、有出血涂片比例比较,差异有统计学意义(P<0.05);两组的病变程度、宫颈重度糜烂、宫颈形态凹凸、宫颈异物比例比较,差异无统计学意义(P>0.05)。多因素logistic分析结果显示,年龄≤30岁(β=0.074,OR=1.077,95%CI=1.023~1.133)、病灶与宫颈管距离≥1 cm(β=0.289,OR=1.335,95%CI=1.106~1.611)、细胞量<40%(β=0.342,OR=1.383,95%CI=1.067~1.791)、有细胞学医生漏诊(β=0.364,OR=1.439,95%CI=1.092~1.897)、无腺细胞或化生细胞(β=0.354,OR=1.412,95%CI=1.112~1.793)、出血涂片(β=0.374,OR=1.454,95%CI=1.107~1.909)是影响患者TCT诊断结果出现假阴性的独立危险因素(P<0.05)。结论患者年龄、病灶与宫颈管距离等因素均可导致TCT诊断假阴性发生,分析相关因素并行相应预防措施能有利于细胞学假阴性情况减少。Objective To analyze the influencing factors of false-negative in thinprep cytolog test(TCT)of patients with cervical intraepithelial neoplasia(CIN).Methods A retrospective analysis was performed on cytological test results of 96 patients with CIN who underwent TCT between April 2019 and May 2021 in Pathological Diagnosis Center,Hu′nan Cancer Hospital.According to the results,negative,i.e.,no intraepithelial lesion or malignant lesion(NILM)was considered as cytological false negative,and cytological false negative patients were selected as observation group and cytological abnormal patients as control group.At the same time,the age,lesion sites and other relevant clinical data of patients in the two groups were counted.The data with statistical differences were analyzed by univariate logistic multifactor analysis,and targeted and effective protective measures were proposed according to the relevant factors.Results TCT showed that there were 12(8.00%)false-negative cases among the 96 patients with CIN,with a false-negative rate of 12.50%.There were statistically significant differences between the observation group and the control group in the proportion of patients≥30 years old,cervical single-site lesion,distance between the lesion and cervical canal≥1 cm,cell concentration<40%,severe cervical inflammation,missed diagnosis by cytology doctor,glandular cells or metaplastic cells,and bleeding smears(P<0.05).There were no statistically significant differences between the two groups in the severity of the disease,severe cervical erosion,irregular cervix and cervical foreign bodies(P>0.05).Multivariate logistic analysis results showed that age≤30(β=0.074,OR=1.077,95%CI=1.023-1.133),distance between the lesion and cervical canal≥1 cm(β=0.289,OR=1.335,95%CI=1.106-1.611),cell concentration<40%(β=0.342,OR=1.383,95%CI=1.067-1.791),missed diagnosis by cytology doctor(β=0.364,OR=1.439,95%CI=1.092-1.897),no glandular cells or metaplastic cells(β=0.354,OR=1.412,95%CI=1.112-1.793),and bleeding smear(β=0.374,OR=

关 键 词：宫颈癌前病变 新柏氏液基细胞学 假阴性 相关因素 

分 类 号：R737.33[医药卫生—肿瘤]