宫颈癌放疗后液基薄层细胞学检测分析

目的分析宫颈癌放疗后宫颈细胞学改变特点及该项检测的临床意义。方法196例宫颈癌放疗后患者放疗结束1个月后行489次宫颈液基薄层细胞学检查(LCT)。采用2001年版TBS诊断系统,对细胞改变作描述性诊断。结果在放疗结束1年内,鳞状上皮表层细胞体积增大不明显、核可增大,但较疏松、胞浆丰富,可出现空泡。部分涂片上可见退变的癌细胞,部分病例见修复细胞和化生细胞。异常鳞状上皮细胞检出率为40.3%,其中不典型鳞状细胞(ASCUS)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)分别为20.1%,5.3%、10.8%。鳞癌(SCC)检出率为3.1%。炎症反应性细胞检出率为42.5%,其中轻、中、重度分别为6.3%,19.4%,16.8%。35例放疗后因细胞学检查异常进行了局部病理组织学检查,病理与LCT两者符合率为91%。结论宫颈液基薄层细胞学可作为宫颈癌放疗后局部有无复发及放射反应的监测指标。

Liquid-based slice cervical cytology test in radiation treated cancer of the uterine cervix

Objective To observe the cervical cytological change after radiation therapy of cancer of uterine cervix and the clinical significance of Liquid-based cytology test(LCT).Methods From 196 uter- ine cervical carcinoma patients,a total of 489 specimens of LCT were collected.All tests were performed one month after the conclusion of radiation treatment.Results Detection rate of abnormal squamous epithelial cells was 40.3%(197/489),of which the findings of atypical squamous cells of undetermined significance (ASCUS),low grade squamous intraepithelial lesion(LSIL),high grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma(SCC) were observed in 20.1%,5.3%,10.8% and 3.1% respec- tively.In benign reactive cervical cell detection,this article mainly describes the detection rate of inflamma- tory reactive cells which was 42.5%,of which the mild 6.34% inflammation took place,19.4% moderate and 6.8% severe inflammation.All kinds of abnormal cell detection rates showed differences among each of the groups from 1 to 18 months of follow-up observation.Conclusions Liquid-based cytology test may al- so be one of the predicting observation indexes if there is recrudescence locally in the future.