TCT与活检病理对早期宫颈癌及宫颈上皮内病变的诊断价值  

Diagnostic Value of TCT and Biopsy Pathology in Early Cervical Cancer and Cervical Intraepithelial Neoplasia

作　　者：牛建新[1] 李丹 尹振宇[1] NIU Jian-xin;LI Dan;YIN Zhen-yu(Department of Pathology,Tianjin Baodi District People's Hospital,Tianjin 301800,China)

机构地区：[1]天津市宝坻区人民医院病理科,天津301800

出　　处：《医学信息》2024年第4期139-142,共4页Journal of Medical Information

摘　　要：目的探究薄层液基细胞学检查(TCT)与活检病理对早期宫颈癌及宫颈上皮内病变(CIN)的诊断价值。方法于2021年1月-2022年12月天津市宝坻区人民医院行TCT筛查的13000例受检者中,取阳性结果者行活检病理检查2200例,比较TCT与活检病理的诊断结果,分析二者对CIN与宫颈癌的诊断符合率、一致性与诊断价值(诊断敏感度、特异度、准确性)。结果TCT与活检病理对CIN的诊断符合率为61.92%(805/1300),TCT与活检病理对宫颈癌的诊断符合率为79.17%(19/24)。经Kappa检验,TCT与病理活检对CIN的诊断一致性良好(Kappa=0.603,P<0.05),TCT与病理活检对宫颈癌的诊断一致性良好(Kappa=0.728,P<0.05)。病理活检诊断CIN与宫颈癌的敏感度、特异度、准确性均高于TCT诊断(P<0.05)。结论TCT与活检病理对CIN与宫颈癌的诊断结果存在较高符合率,二者诊断一致性良好,但活检病理的鉴别诊断价值更高。Objective To explore the diagnostic value of thinprep cytologic test(TCT)and biopsy pathology in early cervical cancer and cervical intraepithelial neoplasia(CIN).Methods Among the 13000 subjects who underwent TCT screening in Tianjin Baodi District People's Hospital from January 2021 to December 2022,2200 patients with positive results underwent biopsy pathology.The diagnostic results of TCT and biopsy pathology were compared,and the diagnostic coincidence rate,consistency and diagnostic value(diagnostic sensitivity,specificity and accuracy)of CIN and cervical cancer were analyzed.Results The coincidence rate of TCT and biopsy pathology in the diagnosis of CIN was 61.92%(805/1300),and the coincidence rate of TCT and biopsy pathology in the diagnosis of cervical cancer was 79.17%(19/24).By Kappa test,TCT and pathological biopsy had good consistency in the diagnosis of CIN(Kappa=0.603,P<0.05),TCT and pathological biopsy had good consistency in the diagnosis of cervical cancer(Kappa=0.728,P<0.05).The sensitivity,specificity and accuracy of pathological biopsy in the diagnosis of CIN and cervical cancer were higher than those of TCT(P<0.05).Conclusion TCT and biopsy pathology have a high coincidence rate in the diagnosis of CIN and cervical cancer,and the diagnostic consistency between the two is good,but the differential diagnosis value of biopsy pathology is more higher.

关 键 词：宫颈癌 宫颈上皮内病变 薄层液基细胞学检查 活检病理 诊断一致性 

分 类 号：R737.33[医药卫生—肿瘤]