液基细胞学配合阴道镜检查诊断宫颈病变

目的探讨液基薄层细胞学（TCT）配合阴道镜检查对子宫颈病变的诊断价值。方法TCT配合阴道镜检查对子宫颈病变进行筛查，以组织学诊断为金标准，对结果进行分析。结果TCT检查2238例，采用TBS分类，共检出阳性涂片201例，占8．98％。其中不典型鳞状上皮细胞（ASC）99例（4．42％）；不典型腺细胞（AGC）4例（0．18％）；低度鳞状上皮内病变（LSIL）63例（2．82％）；高度鳞状上皮内病变（HSIL）28例（1．25％）；鳞状细胞癌（SCC）6例（0．27％）；腺癌（AC）1例（0．045％）。对细胞学阳性（包括ASC及以上病变）或细胞学虽阴性但临床高度可疑者共298例行阴道镜检查，其中251例行镜下活组织病理检查。细胞学与阴道镜下活组织病理诊断符合率分别为LSIL 72．41％（63／87），HSIL 90．32％（CIN2为15／17，CIN3为13／14），SCC 100％（6／6），HPV感染符合率71．11％（32／45）。结论采用TCT筛查，可提高宫颈病变的阳性诊断率；细胞学阳性或临床可疑患者应配合阴道镜检查及镜下活检病理诊断，便于进一步明确诊断，及早治疗。

An investigation on the application of thinprep cytology test and colposcopy in diagnosis of cervical lesion

Objective To evaluate the application of thinprep cytology test and colposcopy in diagnosis of cervical lesion. Methods Outpatient at the department of gynecology of some hospital from April 2004 to April 2005 was screened. Results In all 2 238 cases of cytology classified by TBS,201 positive cases were detected with the rate of 8.98%. 99 cases were found with atypical squamous cells of undermines significance (ASC) ,4 cases atypical glandular cells of undermined significance(AGC), 63 cases with low grade squamous intraepithelial lesions(LSIL), 28 cases with high grade squamous intraepithelial lesions(HSIL), 6 cases with squamous cell carcinoma(SCC ),and 1 case with glandular cell carcinoma, with the detective rate of 4.42%,0.18%,2.82%,1.25%,0.27%,and 0.045% respectively. Positive of cytology or negative of cytology but Suspected patients in clinic amount to 298 cases which were detected by colposcopy,251 cases of them were detected by biopsy. The coincidence rate of the diagnosis was 72.41% for LSIL (63/87), 90.32% for HSIL (CIN2 15/17,CIN3 13/14), 100% for SCC(6/6),71.11% for HPV (32/45). Conclusion The application of thinprep cytology test and colposcopy could enhance the diagnosis rate of cervical lesion. Positive of cytology or negative of cytology but suspected patients in clinic should be detected by colposcopy and biopsy in order to identify the diagnosis and perform early treatment.