液基细胞学结合病理学活检在宫颈病变诊断的应用分析

目的 研究液基细胞学检查（TCT）和病理学活检在宫颈病变诊断中的价值.方法 分析3,710例行TCT检查的患者以及其中719例行阴道镜下活组织检查并有病理结果的临床资料.结果 （1）3,710例TCT中检出上皮内低度病变（LSIL）115例（3.10%）,上皮内高度病变（HSIL）26例（0.70%）,宫颈癌3例（0.08%）.719例行阴道镜下活检,CIN Ⅰ 20例（2.78%）,CIN Ⅱ 37例（5.15%）,CIN Ⅲ 12例（1.67%）;宫颈浸润癌14例（1.95%）;子宫内膜癌3例（0.42%）.（2）TCT与病理学符合率在上皮内低度病变、上皮内高度病变、宫颈癌中分别为7.04%,43.75%,100%,在上皮内高度病变、宫颈癌中具有较高的符合率.（3）各年龄段所占比率在宫颈病理活检阴性组,CIN组和宫颈癌组差别有统计学意义（P〈0.01）.CIN主要集中在20～49岁,宫颈癌发病的中位年龄45.71岁,其发生有年轻化趋势.TCT榆查中阳性率在各年龄组中差别具有统计学意义（P〈0.05）,主要集中在20～49岁组,以30～39岁组最高,50岁以上组明显下降.结论 TCT检查结合病理学活检对CIN和宫颈癌的早期诊断具有熏要价值.

Clinical Analysis of Thinprep Cytology Test and Pathological Biopsy in the Diagnosis of Cervical Lesions

Objective To evaluate the instructive value of thinprep cytology test（TCT） and pathological biopsy in the diagnosis of cervical lesions. Methods 3,710 cases of TCT and 719 cases of biopsy under colposcopy were etrospectively analyzed. Results 115 cases were related with LSIL（3.10%）,26（0.70%） HSIL,3（0.08%）SCC;20 women were histopathologically confirmed to have CIN Ⅰ （2.78%）,37（5.15%） CIN Ⅱ and 12（1.67%）CIN Ⅲ; 14（1.95%）invasive cervical carcinoma,3（0.42%）endometrial carcinoma.The coincidence rates of TCT and pathologic biopsy were 7.04% with LSIL,43.75% with HSIL and 100% with cervical cancer.Age in the biopsy negative group,CIN and SCC had the statistical significance（P〈0.01） as the positive rate in different age group of TCT（P〈0.05）.In the cases of cervical cancer, the middle age of cervical cancer is 45.71 years old,the CIN are 20 - 49 years old while the positive cases of TCT were 30 - 39 years old, older than 50 became decreased. Conclusion TCT and pathological biopsy played an important role in early diagnosis of CIN and cervical carcinoma.