人群大样本子宫颈癌筛查中宫颈涂片的质量控制

目的探索人群大样本子宫颈癌筛查中宫颈涂片质量控制的方法,提高涂片质量和细胞学检查灵敏度。方法概率比随机抽样,常规加跟踪质量控制,肉眼加镜下观察。观察指标:涂片膜厚度、涂片膜面积、血液成分、鳞状上皮细胞数、有无颈管细胞。结果①2008年项目点的后期涂片质量好于前期。肉眼观察涂片膜厚度、血液成分过多、涂片膜面积<40%3项指标后期较前期分别下降0.25%、4.33%、1.51%;镜下观察鳞状上皮细胞数、血细胞过多2项指标分别下降11.79%、11.95%,未见颈管柱状细胞或化生细胞上升3.51%。②2009年项目点涂片质量高于2008年。肉眼观察血液成分过多、涂片膜面积<40%2项指标分别下降0.55%、0.43%,涂片膜厚上升0.58%;镜下观察鳞状上皮细胞数、未见颈管柱状细胞或化生细胞、血细胞过多3项指标分别下降9.61%、4.71%、1.01%。结论建立简便、易行、科学的质量控制方法,能全面监控宫颈癌筛查的涂片质量,及时发现问题提高宫颈涂片质量。

The laboratory quality control of cervical smears in the population-based cervical cancer screening

Objective To improve smear quality and film-reading accuracy,increase the sensitivity of cervical cancer screening through exploring for the laboratory quality control methods of cervical smears in the population-based cervical cancer screening.Methods The data of smear thickness,smear membrane area,blood components,numbers of squamous epithelial cells,with or without endocervical columnar epithelium and the metaplastic cells were taken by sampling proportion,tracking and regular quality control,observed with naked eye and microscope,feedback quality control results of the day and correcting the problem in time.Results Comparing the smear quality of three periods(early,middle,later) in 2008 project,the later period was better than that of the early.Comparing with the early period,the outcome of the smear thickness,blood components and smear membrane area of the later being observed by naked eye decreased by 0.25%,4.34%,1.51% respectively.The amount of squamous cells and blood components were observed by microscope decreased by 11.78%,11.95% respectively.But the amount of without endocervical columnar epithelium or metaplastic cells increased by 3.52%.Comparing the smear quality of 2008-year with that of 2009-year,the results showed that the quality of 2009-year was better.Blood components,membrane area fell up 0.55%,0.44% respectively,while the smear thickness increased 0.58%;the number of squamous epithelial cells,no endocervical columnar epithelium or metaplastic cells,blood components decreased by 9.61%,4.71%,8.25% respectively.Conclusion Establishing the simple,easy,and scientific quality control methods of cervical smears in the population-based cervical cancer screening can fully monitor the quality of cervical smear of multi-project point and identify problems,provide technical guidance and significantly improve the quality of cervical smears.