应用妇科细胞学TBS诊断标准对504例职工妇科普查的结果分析

目的:应用The Bethede System(TBS)诊断标准,对妇科细胞学普查结果及临床应用价值进行评价.方法:妇科宫颈刮片,H.E染色,TBS标准诊断报告.结果:504例宫颈刮片标本,取材满意494例(98.0%),满意但受限10例(2.0%);正常细胞学383例(76.0%),良性细胞改变112例(22.2%),上皮细胞异常改变9例(1.8%),其中癌2例(0.4%).结论:TBS诊断方式全面、具体、可信度大,其报告内容直观易懂,与临床和病理结合更加密切.在职工妇科普查中,应用TBS诊断具有重要意义.     

超薄细胞检测及TBS分类法在宫颈癌筛查中的应用

[目的]对超薄细胞检测系统(thinprep pap test,TPTP)及Bethesda(TBS)细胞学分类法在宫颈癌筛查中的应用价值进行综合评价。[方法]对进行TPT检查及TBS细胞学分类的1209例临床资料进行回顾性分析。[结果]标本满意率93．38％；鳞状上皮异常96例中，未明确诊断意义的鳞状细胞(ASCUS)14例；低度鳞状上皮内瘤变(LSIL)55例，活检证实CINⅠ-Ⅱ级46例(83．64％)，CINⅢ级2例(3．64％)；高度鳞状上皮内瘤变(HSIL)10例，活检证实CINⅢ级及原位癌8例(80％)，CINⅠ-Ⅱ级1例(10％)，鳞癌早浸1例(10％)；TBs诊断为鳞癌者17例，均经病理证实，准确率100％。超薄涂片找到腺癌4例，经活检证实宫颈腺癌2例，子宫内膜癌1例．卵巢癌宫颈转移1例，未明确诊断意义的腺细胞(AGCUS)2例病理均阴性；不典型腺上皮3例，活检及诊刮结果为子宫内膜癌1例，宫颈腺癌1例，阴性1例。[结论]TPT技术应用于宫颈癌筛查能明显提高涂片满意率及宫颈异常细胞检出率。TBS报告方法内容直观、易懂、具体，便于细胞学医生与临床医生之间的沟通．增加了标本的可信度。     

子宫颈部放射治疗后宫颈／阴道细胞学检查及其价值

目的：了解子宫颈癌放射治疗后宫颈／阴道涂片的细胞学特点及临床价值。方法：采用TBS诊断方法，观察300例宫颈癌放疗后涂片的阴道细胞学的改变情况，并评价该检查结果与病理组织学检查结果的符合情况及其临床意义。结果：300例涂片中，发现异常涂片120例，占40％；12例涂片后行病理组织学检查患者中，TBS诊断与病理组织学检查结果定性符合者11例，符合率91．67％。结论：放疗后定期行宫颈／阴道涂片细胞学检查，有助于临床医师观察疗效，了解肿瘤的局部情况。     

宫颈息肉样病变768例临床病理分析

目的 探讨宫颈息肉样病变的临床特点、病理类型。方法 回顾分析768例宫颈息肉样病变的临床病理资料并分类。结果 768例中，745例(97．01％)为宫颈息肉，23例(2．99％)为真性肿瘤，其中恶性肿瘤11例。结论 在诊断宫颈息肉时应与真性肿瘤鉴别，少数宫颈息肉具有恶性潜能。     

子宫颈癌放射治疗后宫颈／阴道细胞学检查及其价值

目的：了解子宫颈癌放射治疗后宫颈／阴道涂片的细胞学特点及临床价值。方法：采用TBS诊断方法，观察300例宫颈癌放疗后涂片的阴道细胞学的改变情况，并评价该检查结果与病理组织学检查结果的符合情况及其临床意义。结果：300例涂片中，发现异常涂片120例，占40％；12例涂片后行病理组织学检查患者中，TBS诊断与病理组织学检查结果定性符合者11例，符合率91.67％。结论：放疗后定期行宫颈／阴道涂片细胞学检查，有助于临床医师观察疗效，了解肿瘤的局部情况。     

妇科快速冰冻切片348例诊断分析

对３４８例妇科肿瘤冰冻切片的原始诊断与石蜡切片对照进行回顾性分析。结果确诊率９６．８４％，未确诊率０．８６％，误诊率２．２９％，假阳性率１．４３％，假阴性率０．８６％。与国内外妇科肿瘤诊断的资料相比较，确诊率与误诊率相仿。本言语主演 着重分析误诊的原因及预防措施。     

细胞因子诱导的杀伤细胞治疗中晚期妇科肿瘤的临床研究

目的评估细胞因子诱导的杀伤细胞（CIK细胞）过继免疫疗法治疗中晚期妇科肿瘤的临床疗效。方法参照美国斯坦福大学骨髓移植中心建立的CIK细胞培养方法诱导扩增CIK细胞。培养14d后分次回输给病人，观察病人治疗前后瘤体、肿瘤标志物、免疫指标、临床症状、生活质量、卡氏评分等变化，同时记录生存期。结果在32例接受CIK细胞治疗的中晚期妇科肿瘤病人中，CR＋PR＋MR为28例，总缓解率为87．5％，随访1a生存率为90．6％，2a生存率为81．3％，3a生存率为75．0％。临床症状治疗前、后有明显改善（P〈0．05）；生存质量卡氏评分提高率为78．1％；肿瘤标志物CA199有显著性差异（t=3．95，P〈0．05）；体重多数有增加。结论CIK细胞对为那些手术、放疗、化疗已无适应症的中晚期妇科肿瘤病人提供了一种可以继续延长生存期，提高生活质量的新途径。     

Survivin分子信标用于诊断宫颈癌临床价值的初步探讨

目的：评价Survivin分子信标在宫颈癌诊断中的敏感性和特异性，预测其在宫颈癌早期诊断中的应用价值。方法：应用已验证的Survivin分子信标检测临床宫颈癌患者及健康对照者的宫颈细胞学刮片，并用相应的肿瘤组织行Western—blot检测作为进一步验证。结果：44例宫颈癌患者的宫颈刮片样本中Survivin分子信标检测阳性者27例，敏感性61．37％，特异性为72．72％；Westem—blot检测敏感性为76．1％。结论：Sur—vivin分子信标在检测宫颈癌中有较好的敏感性和特异性，其荧光表达强度与Western—blot检测的蛋白表达浓度成正比；可能是一种可行的、有效的宫颈癌早期诊断及术后随访检测方法。     

妇科快速冰冻切片348例诊断分析

对３４８例妇科肿瘤冰冻切片的原始诊断与石蜡切片对照进行回顾性分析。结果确诊率９６．８４％，未确诊率０．８６％，误诊率２．２９％，假阳性率１．４３％，假阴性率０．８６％。与国内外妇科肿瘤诊断的资料相比较，确诊率与误诊率相仿。本文还着重分析误诊的原因及预防措施。     

宫颈锥切在宫颈上皮内瘤变诊治中的作用

目的：探讨宫颈锥切术在子宫颈上皮内瘤变的诊断及治疗过程中的作用。方法：整理5年来我院宫颈锥切病人49例，对比其一般资料、细胞学、阴道镜下活检及锥切病理报告。结果：宫颈锥切的病人逐年增加。29例(59．2％)细胞学与阴道镜下活检结果一致，20例(40．8％)不一致。18例(36．7％)宫颈锥切与阴道镜下多点活检病理检查结果一致；31例(63.3％)不一致，其中6例(12．2％)宫颈锥切术后病理较阴道镜下多点活检重，25例(51．0％)较阴道镜下多点活检轻。结论：宫颈锥切术是子宫颈上皮肉瘤变病变程度的高级确诊手段，对其他诊断方法有疑问的病例尤其实用。并且，随着CIN及年轻宫颈癌的增多，宫颈锥切术成为有生育要求的年轻患者较恰当的治疗选择。     

Prevalence of abnormal Papanicolaou smears and cytohistological correlation: A study from Aga Khan University Hospital, Pakistan

Objectives: To determine the prevalence of abnormal Papanicolaou (Pap) smears in patients visiting the gynecologic outpatient department at Aga Khan University Hospital, Karachi (AKUH) and their cytohistologic correlation. This data was also compared with other international institutions. Methods: A database search of all abnormal cervical cytological cases diagnosed in the gynecologic outpatient department at Aga Khan University Hospital in the last 10 years (i.e. from 1994 to 2004), as well as their follow‐up biopsies, was carried out. The data was then analyzed. Results: Of the 66 617 Pap smears reviewed, 95% of cases had a diagnosis of ‘negative’, 2% of smears were labeled as ‘inadequate’, 0.54% Pap smears showed dysplastic changes, and 0.14% were labeled as ‘malignant’. These numbers are less than figures in Western countires, but are comparable with Asian figures. The pick‐up rate for abnormal Pap smears was 8/1000, while the overall concordance rate was 74%; positive predictive values for high‐grade cervical lesions and for carcinomas was high 92–100%, respectively; while for ASCUS and low‐grade cervical lesion was 35% and 67%, respectively. A total number of 8 cases were identified where there was a discrepancy between cytological and histological diagnosis, they were reviewed critically. Conclusion: In most of the developing countries effective Pap screening faces certain barriers. This includes limited or poor quality of cytology services. In a low‐resource country like Pakistan there is a subset of patients (those with atypical cellular abnormalities) who may benefit from repeat smears instead of early cervical biopsies. In order to improve the efficacy of our cytology services, we need to develop specific clinical protocols for subsequent management of abnormal smears.     

Predictive value of thyroglobulin changes for the efficacy of thyroid remnant ablation.

The aim of this case-control study was to determine the utility of the evaluation of changes in serum thyroglobulin (Tg) levels before and after 1311 diagnostic total body scan (TBS) in patients with thyroid cancer to predict the efficacy of radioiodine ablation. Among 134 consecutive patients with differentiated thyroid carcinoma (DTC) who had undergone a thyroidectomy and TBS prior to radioiodine ablation, we selected those subjects with no evidence of distant metastases and with two consecutive assessments of Tg before TBS and radioiodine ablation within a period of four weeks. With this selection procedure 27 patients (22 with papillary and five with follicular carcinomas) were included in our evaluation. The ablation therapy was considered successful when the TBS performed one year after treatment did not show any or less than 1% cervical 131I uptake, Tg levels remained below 3 ng/mL, and clinical and instrumental examinations were negative for the presence of relapses. These criteria divided the selected patients into two subsets: patients with successful radioiodine ablation and patients with residual thyroid tissue. The majority of patients with unsuccessful ablation showed an increase in serum Tg levels, while most of the patients with successful ablation showed a steady decrease in Tg concentrations. Statistical analysis evidenced that the increase in Tg levels after TBS was related to unsuccessful ablation (P > or = 0.01). By contrast, the rate of thyroid remnants with 131I uptake did not show any relationship with the outcome of ablation therapy. The group of patients with increasing Tg levels after TBS had a relative risk of 3.3 of unsuccessful ablative therapy compared to the group with stable or decreasing Tg levels. This study supports the concept that by monitoring Tg levels in patients who undergo diagnostic TBS before radioiodine ablation it is possible to obtain useful information about the efficacy of 131I therapy.     

Review of the Bethesda System atlas does not improve reproducibility or accuracy in the classification of atypical squamous cells of undetermined significance smears

BACKGROUND: The Bethesda System (TBS) and its accompanying atlas were developed to promote uniform diagnosis and reporting of cervical and vaginal cytology, especially with respect to borderline abnormal smears. The authors assessed whether group study of TBS atlas improves the reproducibility and accuracy of the cytopathologic diagnosis of equivocal Papanicolaou smears. METHODS: One hundred "atypical" smears were divided into pretest and posttest sets containing equal numbers of negative, atypical squamous cells of undetermined significance (ASCUS), and squamous intraepithelial lesion (SIL) diagnoses based on a five-member panel review. Two comparable teams of four pathologists from George Washington University Medical Center (Washington, DC) and Kaiser Permanente (Portland, OR), each comprised of two more experienced cytopathologists and two less experienced pathologists, independently reviewed the 50 pretest slides and classified the slides according to TBS as negative, ASCUS, or SIL. The teams then conducted group study sessions using TBS atlas. After the review, the pathologists independently classified the 50 posttest slides in a similar manner. RESULTS: Pretest, pair-wise interobserver agreement ranged from 30% to 66% compared with 34-62% for posttest agreement. Absolute percent agreement of reviewers' diagnoses with a previously developed consensus diagnosis based on opinions of a five-expert panel (cytopathologic certainty scale) ranged from 44% to 62% for the pretest set and from 40% to 60% for the posttest set. Comparison of the detection of oncogenic human papilloma virus (HPV) DNA by hybrid capture tube test with smears classified as negative, ASCUS, or SIL revealed that seven of eight reviewers did not demonstrate a stronger association between HPV detection and cytologic diagnosis in the posttest set. CONCLUSIONS: Review of TBS atlas by itself does not appear to improve the reproducibility or accuracy of cytologic diagnoses. The lack of improvement was similar among the pathologists involved regardless of experience level or whether they had a close working relation. Cancer (Cancer Cytopathol) Copyright 2000 American Cancer Society.     

Adenocarcinoma in situ of the uterine cervix: screening and diagnostic errors in Papanicolaou smears

BACKGROUND: Little attention has been given to the reasons for failure to detect adenocarcinoma in situ (AIS) of the uterine cervix in Papanicolaou (Pap) smears. In the current study, the authors examined a series of screening or diagnostic errors in cases in which the final histologic diagnosis was either AIS or AIS combined with a high-grade squamous intraepithelial lesion (AIS + HSIL). METHODS: Smears obtained in the 3 years before histologically proven AIS or AIS + HSIL was diagnosed and within a specified 6-year period (1993-1998) were reviewed and reclassified. All were conventional Pap smears. The smears studied were those with a review diagnosis of possible or definite high-grade epithelial abnormality that initially were reported by a cytotechnologist to be negative (screening error) or that were reported by a pathologist to be negative, unsatisfactory, or indicative of a low-grade epithelial abnormality (diagnostic error). A semiquantitative, blinded assessment of the frequency of cytologic criteria for the diagnosis of AIS was made for smears with erroneous diagnoses compared with a series of smears that yielded true-positive findings. RESULTS: Sampling errors, which were defined as cases in which smears did not have sufficient evidence for a diagnosis of possible or definite AIS or HSIL on review, accounted for 35.1% and 36% of all smears from patients with a biopsy diagnosis of AIS and patients with a biopsy diagnosis of AIS + HSIL, respectively. With regard to AIS, there were 3 screening errors and 5 diagnostic errors, accounting for 10.4% of 77 smears. Minimal, poorly preserved material was evident in four smears, including three smears with only one sheet of abnormal glandular cells. In four other smears, there was a moderate amount of adequately preserved glandular material, mainly in large sheets, with varying degrees of crowding and hyperchromasia. With regard to AIS + HSIL, there were 6 screening errors and 6 diagnostic errors, accounting for 13.5% of 89 smears. In those smears, there generally was a moderate amount of abnormal material in the form of crowded groups of suboptimally preserved, hyperchromatic squamous cells. Only two of those smears yielded findings of possible abnormal glandular cells. Only 3 of 20 errors occurred in smears that were examined during the last 3 years of the study. In the semiquantitative assessment, smears with erroneous findings were shown to contain far less abnormal material than true-positive smears and to exhibit a corresponding paucity of diagnostic criteria. CONCLUSIONS: Sampling errors were the main cause of false-negative reports in cases of AIS and AIS + HSIL. The primary factors that contributed to screening or diagnostic errors in AIS were minimal, poorly preserved abnormal material and an overly conservative approach to the assessment of unusual large sheets or aggregates of glandular cells. With regard to AIS + HSIL, most laboratory errors were related to the presence of crowded groups of squamous epithelial cells. There were fewer errors in the last 3 years of the study, raising the possibility of improvement over time.     

Diagnostic Accuracy of Screening of Lip and Oral Cavity Cancers or Potentially Malignant Disorders (PMD) by Frontline Workers: A Systematic Review and Meta-Analysis

Background: Oral cancer screening strategies help reduce associated mortality and could be performed by a trained frontline health worker (FHW). The present review aims to assess the diagnostic accuracy of commonly used screening modalities for oral cancer performed by FHW in apparently healthy individuals. Methods: Electronic databases PubMed, Scopus, Embase, Cochrane Library, and Google Scholar, were searched. The review included studies conducted where apparently healthy adult individuals were screened by the FHW for cancer or PMD of the lip and oral cavity by any of the four commonly used techniques – Conventional Oral Examination (COE), toluidine blue staining (TBS), Oral Cytology (OC), and Chemiluminescent Illumination (CLI). Findings: A total of 2,413 potentially relevant articles were retrieved from the search, among which five studies for COE were included in the review. Four out of those five studies were done before the year 2000. None of the studies fitted the inclusion criteria for TBS, OC, and CLI. Pooled sensitivity of oral screening by COE performed by an FHW (n=5) was 88.8% (95% CI: 71.6-96.1), whereas pooled specificity was 91.9% (95% CI: 78.3-97.3). On subgroup analysis, the pooled sensitivity and specificity of studies where the prevalence of disease was <50% (n=4) was 84.5% (95% CI: 62.6 – 94.7) and 94.1% (95% CI: 82.2 – 98.2), respectively. Interpretation: COE by trained FHW had high pooled sensitivity and specificity for screening of oral cancer and PMDs. The screening techniques TBS, OC, and CLI, were not studied for mass screening by trained FHW. COE by trained FHW could be utilized for oral screening in limited-resource settings. However, the FHW should be sufficiently trained to get the desired benefits of early detection. Funding: Department of Health Research, Ministry of Health & Family Welfare, Government of India.     

Applicability of the Bethesda System 2001 to a public health setting

BACKGROUND: The degree of applicability of the Bethesda System 2001 (TBS 2001) for cervicovaginal cytology to a public health setting is unknown, and extrapolations from available data are unwarranted. METHODS: A "before/after" study design was used to evaluate the impact of TBS 2001 on an organized, population-based screening program in northern Italy. Between 2003-2004, 6 cytology laboratories converted from TBS 1991 to TBS 2001. A set of screening indicators based on TBS 2001 (85,012 patients) were compared with those based on TBS 1991 (199,833 patients) by means of their laboratory- and patient age-standardized ratio with a 95% confidence interval (CI). RESULTS: The prevalence of cervical intraepithelial neoplasm (CIN)2-3/carcinoma was stable between the 2 populations. TBS 2001 had no effect on the unsatisfactory rate (1.99% vs. 2.03% for TBS 1991) nor on follow-up compliance rate (93.2% vs. 92.3%). The reporting rate of atypical squamous cells (ASC) decreased from 17.1 to 14.7 per 1000 (ratio, 0.86; 95% CI, 0.81-0.91), the total positivity rate from 31.1 to 29.0 per 1000 (ratio, 0.93; 95% CI, 0.90-0.97), and the ASC:SIL (squamous intraepithelial lesion) ratio from 1.38 to 1.16. Compared with the ASCUS (ASC of undetermined significance) reports of TBS 1991, the predictive value for CIN2-3/carcinoma decreased from 5.2 to 3.5% (ratio, 0.68; 95% CI, 0.48-0.93) among ASCUS reports, but increased from 5.1 to 17.2% (ratio, 3.41; 95% CI, 1.64-6.28) among ASC-cannot exclude high grade lesion (ASC-H) reports. ASC-H had a 5.01-fold (95% CI, 2.23-10.2) greater predictive value than ASCUS. CONCLUSIONS: TBS 2001 is applicable to cervical screening in a public health setting.     

Adenocarcinoma of the cervix

BACKGROUND: The current study examines 1) the sensitivity of detection of invasive adenocarcinoma of the cervix in a routine cervical screening service, and 2) the frequency in smears of cytologic criteria previously found to be useful in diagnosis. METHODS: Data on women with diagnoses of adenocarcinoma of the cervix accessioned at the Western Australian Cervical Cytology Registry during the period 1993-1998 were examined, where smears had been reported by Western Diagnostic Pathology within three years of the biopsy diagnosis. Smears and biopsy material were reviewed. RESULTS: Thirty-six smears from 24 women were reviewed. Of those, 58.3% had been reported as a possible or definite high grade epithelial abnormality (HGEA). On review it was thought that this could be improved to 77.8%. The screening or diagnostic error was thus 19.4% and the sampling error 22.2%. The likelihood of an individual woman receiving a report of a possible or definite HGEA in the three years before biopsy was 83.3%. In retrospect this could have been improved to 91.7%. Heavy bloodstaining with abundant abnormal glandular epithelium (14 smears) and small three-dimensional or papillary clusters (16 smears) were the most frequent clues to invasion. Tumor necrosis/diathesis was present in eight smears, but easily seen in only four, while marked nuclear pleomorphism and macronucleoli were seen in three and one smears respectively. In cases with a discrepancy between the initial and the review findings, very small amounts of abnormal material (three smears), a resemblance to endometrial cells (one smear), and an unusual appearance of folded monolayered sheets (three smears) contributed to the difficulty of diagnosis. CONCLUSIONS: There were significant sampling and screening/diagnostic errors (22.2% and 19.4%, respectively). Screening and diagnostic errors could perhaps be reduced by a greater awareness of the range of cytologic changes, but these may be subtle. Heavy bloodstaining with abundant abnormal glandular material may be a useful clue to invasive, rather than in situ, adenocarcinoma, even in the absence of tumor diathesis or fully malignant nuclear criteria.     

Evaluation of PathTezt™, a Liquid-Based Cytology System

Liquid-based preparation (LBP) cytology is commonly used in most laboratories these days due to its convenience and reliable results for the cervical cancer screening program. The PathTezt™ Liquid-based Pap smear is a second-generation LBP, which uses a filter-based concentration technique in processing the sample. Objective: This study was done to evaluate the cellular fixation, morphology, quality of smear in gynae cytology, and diagnostic interpretation of cervical cytological smears produced by the PathTezt liquid-based processor. Materials and Methods: A total of 400 pap smear samples were taken and processed using the PathTezt 2000 processor. The slides were evaluated in terms of sample adequacy, percentage of the circle covered by epithelial cells, cellular distribution, obscuring factors, and cell fixation. Results: About 95.25% (381) of the samples were satisfactory for the evaluation. In 19 (4.75%) of the samples, epithelial cells covered less than 50% of the circle. A sample with good cellular distribution was seen in 92% of the cases, while 354 (88.5%) samples showed minimal inflammatory background. Almost all the smears (95.75%) had no erythrocytes in the background. All smears showed good quality fixation features toward nuclear, cytoplasm, and microorganisms. The total performance rate was 99%. Conclusion: Although the PathTezt liquid-based processor is still new compared to other first-generation LBP, the smears produced by this method were of high quality and it was cost-effective.     

Incidence and clinical significance of morphologically benign-appearing endometrial cells in patients age 40 years or older: the impact of the 2001 Bethesda System

BACKGROUND: The 2001 Bethesda System (TBS 2001) introduced a new diagnostic category-normal endometrial cells in women age 40 years or older (EM >or= 40). The objective of the current study was to determine whether there was any significant increase in the frequency with which this diagnosis was reported after the implementation of TBS 2001 and the clinical significance of this diagnosis. METHODS: All women who had a Papanicolaou (Pap) test and a diagnosis of EM >or= 40 between January 1999 to December 2003 were identified. Follow-up included repeat Pap tests and/or surgical pathology. TBS 2001 was implemented on January 1, 2002. RESULTS: In total, 556 Pap tests with a diagnosis of EM >or= 40 were identified, accounting for 0.52% of the 106,204 Pap tests evaluated during the study period. The incidence of EM >or= 40 before and after implementation of the new TBS was 0.47% and 0.61%, respectively, and showed a statistically significant difference. One hundred four patients (19%) underwent endometrial tissue sampling, including 22 patients who underwent hysterectomy (4%) and 82 patients who underwent endometrial biopsy (15%). Overall, 1 patient (2%) had significant endometrial pathology, namely, complex endometrial hyperplasia without atypia. CONCLUSIONS: A significant increase in the incidence of EM >or= 40 was observed with the implementation of TBS 2001. However, there was no difference in the proportion of patients that underwent endometrial tissue sampling. In addition, the incidence of clinically significant endometrial lesions associated with such a diagnosis was very low. The authors recommend that women with benign endometrial cells on Pap tests in women age 40 years or older should undergo endometrial biopsy only when additional clinical indicators are identified.     

广东地区37万例妇女子宫颈细胞学筛查子宫颈病变的研究

Objective:Analysis of the results of 37 million cases by using cervical liquid-based cytology screening.discussion the situation of cervical cancer and precancerous lesions in Guangdong province.Methods:From 2002 to 2006.using liquid-based thin-layer cytology (TCT)method screening cervical lesions within 371.929 women in Guangdong.Cytological diagnosis adopt TBS(the Bethesda system)Standard(TBS improved 2001 version of the diagnostic criteria),staastic positive rate by age and region respectively.Results:371,929 cases of gynecology cervical samples in Guangdong.331,251 cases were negative,accounted for 91.23%:cytology positive cases:32,548 cases were squamous intreepithelial lesions(8.96%),486 cases were glandular epithelial lesions(0.13%):grouped according to age:30 to 40-year-old positive rate was 9.13%,40 to 50-year-old positive rate was 9.60%.the latter had higher cytology positive rate;grouped according to region:the total samples in PRD areas were 304.951 cases,accounted for 81.99%,in which 24301 cases were positive(8.14%),in 66978 cases(18.01%)of NON-PRD regions,7645 cases were positive(11.87%),there were 1858 cases had biopsy/follow-up results from 2004t02005.and the rate was 2.88%.Conclusion:The cytological positive rate of cervical cancer and its pre-cancerous lesions was 9.09%in Guangdong(of which the rate of cytological diagnosis as precancerous lesions was 3.40%),30 to 50 age group had the high incidence of cervical cancer and its precursor lesions.and also the main stage of prevention for cervical cancer.Cytology positive rate was 11.87% in economic underdevelopment Non-Pead River Delta regions.much higher than the Pearl River Delta region.