宫颈活检病理774例与液基细胞学结果对照分析

目的：探讨宫颈CIN液基细胞学结果与组织病理学诊断的符合率及对子宫颈病变的诊断价值。方法：选择774例在我院妇科门诊因宫颈细胞学异常做宫颈活检病理诊断患者的临床及病理资料进行回顾性分析。结果：液基细胞学检查显示：（ASC＋AGC）388例（50.1%）;（ASC-H）56例（7.2%）;（LSIL）237例（30.6%）;（HSIL）93例（12.0%）宫颈活检为慢性炎症289例（37.3%）CINⅠ级301例（38.8%）CINⅡ级100例（12.9%）CINⅢ级（含原位癌）77例（9.9%,重度不典型增生70例,原位癌7例）。宫颈浸润癌7例（0.9%）。有少数病例上皮内低度病变,病理组织学亦为CINⅢ级。细胞学显示高度上皮内病变高发年龄组为30-39岁组,病理活检显示高级别CIN（CINⅡ、Ⅲ级）高发年龄组为30-39岁组,与细胞学组二者相同。结论：液基细胞学与病理组织学有较高的符合率,对高级别CIN和宫颈癌诊断准确率高,配合病理活检能及早发现CINⅢ级或原位癌,诊断为宫颈上皮内瘤变均应做病理活检,以防漏诊。

Compared analysis of cervical histopathology and liquid-based cervical cytology in 774 cases

Objective To investigate the diagnose accordance rate of the CIN liquid-based cervical cytology and histopathology,and to investigate the diagnostic value of the CIN liquid-based cervical cytology for cervical lesions.Method Total 774 cases of abnormal cervical cytology were chosen for cervical biopsy in the Gynecology Outpatient Clinic of our hospital from January 2005 to October 2006,and their clinical and pathological data were reviewed.The age distributions of incidence were compared between the two groups.Results The liquid-based cytology showed:(ASC + AGC) of 388 cases(50.1%);ASC-H of 56 cases(7.2%);LSIL of 237 cases(30.6%);HSIL of 93 cases(12.0 %).Cervical biopsy: chronic inflammation of 289 cases(37.3%);CIN I of 301 cases(38.8%);CIN Ⅱof 100 cases(12.9%);CIN Ⅲ(including carcinoma in situ) of 77 cases(9.9%,70 cases of severe dysplasia,7 cases of carcinoma in situ);7 cases of cervical carcinoma(0.9%).A few cases of low grade squamous intraepithelial lesion were diagnosed as CIN Ⅲ by histopathology.Cytology showed that the high-incidence age group of high grade squamous intraepithelial lesion was the 30~39 years old group.The biopsy showed that the high-incidence age group of CIN(CIN Ⅱ,Ⅲ) was the 30~39 years old group,which was the same as the result of cytology.Conclusion The diagnose accordance rate of the liquid-based cervical cytology,which shows a high rate of accuracy for high-level CIN and cervical cancer diagnose,is well consistent with histopathology.Each case diagnosed as CIN by liquid-based cervical cytology should be diagnosed by biopsy to avoid misdiagnosis,so that CIN Ⅲ or carcinoma in situ will be diagnosed in time.