宫颈薄层液基细胞技术联合阴道镜对宫颈病变的诊断价值

目的 探讨官颈薄层液基细胞技术(thinPrep cytologic test,TCT)联合阴道镜对宫颈病变的诊断价值.方法 选取2009年10月至2011年10月成都市第六人民医院妇产科门诊行TCT检查结果 阳性患者150例(观察组)行阴道镜下活检,随机抽取135例可疑宫颈病变患者(对照组)直接行阴道镜下活检,以病理诊断为金标准,比较两组问差异.结果 TCT结合阴道镜检查诊断炎症或其它良性病变的灵敏度为94.12%、特异度81.54%、诊断符合率88.67%,诊断宫颈上皮内瘤变(CIN)的灵敏度为81.25%、特异度94.19%、诊断符合率88.67%,诊断SCC的灵敏度、特异度和诊断符合率均为100%;直接阴道镜下检查诊断炎症或其它良性病变的灵敏度为74.36%、特异度47.37%、诊断符合率62.96%,诊断CIN的灵敏度为62.96%、特异度73.75%、诊断符合率73.75%,诊断鳞状细胞癌(SCC)的灵敏度为73.75%、特异度33.33%、诊断符合率1.48%.两组诊断宫颈病变的灵敏度、特异度和诊断符合率比较,差异均有统计学意义(P<0.05).结论 TCT联合阴道镜检查是诊断宫颈病变的重要方法,能提高宫颈癌前病变检出率.

Diagnostic value of thinPrep cytologic test combined with colposcopy for cervical lesions

To evaluate the diagnostic value of thinPrep cytologic test（TCT）combined with colposcopy for cervical lesions. Biopsy under colposcopy was carried out for 150 women with positive TCT results（Study Group）and 135 women with suspicious cervical lesions（Control Group）in Chengdu No.6 People＇s Hospital from Oct 2009 to Oct 2011.Pathological diagnosis was used as the standard to compare the difference between the two groups. The sensitivity,specificity and diagnose accordance rates of TCT combined with colposcopy for cervical lesions were 94.12%,81.54%and 88.67%respectively,those for cervical intraepithelial neoplasia（CIN） were 81.25%,94.19%and 88.67%respectively,and those for squamous cell carcin oma（SCC） were 100%respectively.The sensitivity,specificity and diagnose accordance rates of colposcopy for inflammation and other benign lesions were 74.36%,47.37%and 62.96%respectively,those for CIN were 62.96%,73.75%and 73.75%respectively,and those for SCC were 73.75%,33.33%and 1.48%.Differences were significant between the two groups in the sensitivity,specificity and diagnose accordance rates（P 0.05）. TCT combined with colposcopy is an important diagnostic method for cervical lesions.It can improve the detection rate of precancerous cervical lesions.