液基薄层细胞学检测在宫颈上皮内瘤变和宫颈癌诊断中的应用价值分析(1)
【摘要】目的：探讨液基薄层细胞学技术(TCT) 在诊断宫颈上皮内瘤变及宫颈癌中的应用价值。方法：选取2012年6月至2013年12月期间在我院接受宫颈病变筛查的681例患者作为研究对象，行TCT检查及阴道镜下宫颈活检，探讨年龄与发病率的关系，同时对比研究TCT细胞学与组织学诊断结果。结果：TCT阳性率多见于36～45岁年龄段；TCT细胞学诊断ASC-H 60例，ASC-US 222例，LSIL 89例，HSIC 14例，SCC 5例，AGC 2例；组织学诊断CINI 178例，CINⅡ 114例，CINⅢ 33例，SCC 13例，以组织学诊断为金标准， ASC-H符合率为9167%(55/60)，ASC-US为3423%(76/222)，LSIL为8764%(78/89)，HSIC为9286%(13/14)，SCC为100%(2/2)。结论：液基薄层细胞学技术(TCT)具有较高的阳性检出率，是筛查宫颈上皮病变的重要手段，有助于宫颈上皮内瘤变和宫颈癌的早期诊断及治疗。
【关键词】 液基薄层细胞学技术；宫颈上皮内瘤变；宫颈癌；诊断价值
The application of TCT in the diagnosis of cervical epithelial lesions and cervical cancerHAN Yixu， ZENG Xin. Department of Obstetrics and Gynecology， Hainan Nongken General Hospital， Haikou 570203， China
【Abstract】Objectives： To investigate the application value of TCT in the diagnosis of cervical epithelial lesions and cervical cancer. Methods： 681 patients that received cervical lesions screening in our department from June 2012 to December 2013 were selected and were tested by TCT and colposcopy cervical biopsy. The relationship between age and incidence rate was explored， and results of TCT cytological and histological diagnosis were compared. Results： The positive rate of TCT was higher in patients of 36～45 years old. There were ASC-H (60 cases)， ASC-US (222 cases)， LSIL(89 cases)， HSIC (14 cases)， SCC (5 cases) and AGC (2 cases) diagnosed by TCT cytology， and 178 cases of CINI， 114 cases of CIN II，33 cases of CIN III and 13 cases of SCC diagnosed by TCT. Choosing histological diagnosis as the gold standard， the coincidence rate ofASC-H， ASC-US， LSIL， HSIC and SCC were 91.67% (55/60)， 34.23% (76/222)， 87.64% (78/89)， 92.86% (13/14) and 100% (2/2) respectively. Conclusion： With a high positive rate， TCT is an important screening means for cervical intraepithelial lesions， which is conducive to early diagnosis and treatment of cervical intraepithelial neoplasia and cervical carcinoma.
【Key words】TCT； Cervical intraepithelial neoplasia； Cervical cancer； Diagnostic value
【中图分类号】R167【文献标志码】A
宫颈癌属于女性最常见的恶性肿瘤，在我国发病率及死亡率约占世界的35%，且每年新发宫颈癌病例超过11万，发病呈年轻化趋势[1，2]。宫颈上皮内瘤变(cervical intraepithelial neoplasia， CIN)是与宫颈癌相关的癌前病变的统称，可分为宫颈不典型增生及宫颈原位癌，是宫颈癌进展过程中的必经阶段[3，4]。有效的筛查手段是早期诊断及治疗宫颈上皮内瘤变的关键。宫颈上皮病变发展到宫颈癌需经历较长可逆转阶段，因此，宫颈细胞学检查是预防宫颈癌发生及发展的主要手段。作为一种传统的宫颈癌筛查方法，巴氏涂片法不能完全反映宫颈病变状态，假阴性率高达50%以上，主要由制片误差所致，不符合临床诊断要求。液基薄层细胞学涂片(Thinprep cytological test，TCT) 是新引进的宫颈癌筛查技术，采用薄层细胞检测系统检测宫颈细胞并进行细胞学分类，可提高宫颈癌前病变检出率，进而降低宫颈癌的发生率。本文总结了681例患者的TCT及电子阴道镜下宫颈活组织病理检查资料，并进行回顾性分析，旨在探讨TCT在宫颈上皮内瘤变和宫颈癌诊断中的应用价值。, http://www.100md.com(韩一栩 曾新)
【关键词】 液基薄层细胞学技术；宫颈上皮内瘤变；宫颈癌；诊断价值
The application of TCT in the diagnosis of cervical epithelial lesions and cervical cancerHAN Yixu， ZENG Xin. Department of Obstetrics and Gynecology， Hainan Nongken General Hospital， Haikou 570203， China
【Abstract】Objectives： To investigate the application value of TCT in the diagnosis of cervical epithelial lesions and cervical cancer. Methods： 681 patients that received cervical lesions screening in our department from June 2012 to December 2013 were selected and were tested by TCT and colposcopy cervical biopsy. The relationship between age and incidence rate was explored， and results of TCT cytological and histological diagnosis were compared. Results： The positive rate of TCT was higher in patients of 36～45 years old. There were ASC-H (60 cases)， ASC-US (222 cases)， LSIL(89 cases)， HSIC (14 cases)， SCC (5 cases) and AGC (2 cases) diagnosed by TCT cytology， and 178 cases of CINI， 114 cases of CIN II，33 cases of CIN III and 13 cases of SCC diagnosed by TCT. Choosing histological diagnosis as the gold standard， the coincidence rate ofASC-H， ASC-US， LSIL， HSIC and SCC were 91.67% (55/60)， 34.23% (76/222)， 87.64% (78/89)， 92.86% (13/14) and 100% (2/2) respectively. Conclusion： With a high positive rate， TCT is an important screening means for cervical intraepithelial lesions， which is conducive to early diagnosis and treatment of cervical intraepithelial neoplasia and cervical carcinoma.
【Key words】TCT； Cervical intraepithelial neoplasia； Cervical cancer； Diagnostic value
【中图分类号】R167【文献标志码】A
宫颈癌属于女性最常见的恶性肿瘤，在我国发病率及死亡率约占世界的35%，且每年新发宫颈癌病例超过11万，发病呈年轻化趋势[1，2]。宫颈上皮内瘤变(cervical intraepithelial neoplasia， CIN)是与宫颈癌相关的癌前病变的统称，可分为宫颈不典型增生及宫颈原位癌，是宫颈癌进展过程中的必经阶段[3，4]。有效的筛查手段是早期诊断及治疗宫颈上皮内瘤变的关键。宫颈上皮病变发展到宫颈癌需经历较长可逆转阶段，因此，宫颈细胞学检查是预防宫颈癌发生及发展的主要手段。作为一种传统的宫颈癌筛查方法，巴氏涂片法不能完全反映宫颈病变状态，假阴性率高达50%以上，主要由制片误差所致，不符合临床诊断要求。液基薄层细胞学涂片(Thinprep cytological test，TCT) 是新引进的宫颈癌筛查技术，采用薄层细胞检测系统检测宫颈细胞并进行细胞学分类，可提高宫颈癌前病变检出率，进而降低宫颈癌的发生率。本文总结了681例患者的TCT及电子阴道镜下宫颈活组织病理检查资料，并进行回顾性分析，旨在探讨TCT在宫颈上皮内瘤变和宫颈癌诊断中的应用价值。, http://www.100md.com(韩一栩 曾新)