河北省10 111例宫颈薄层液基细胞学检查结果及诊断分析

目的 分析河北省人民医院就诊10 111例妇女宫颈薄层液基细胞学（thinprep cytologic test,TCT）结果,观察宫颈病变发生情况及分布特点。方法 回顾性分析2016年12月5日—2018年2月5日在河北省人民医院妇科门诊就诊的10 111例患者TCT检验结果,比对诊断为宫颈上皮不典型鳞状上皮细胞(atypical squamous cells of undetermined signification,ASC-US)及以上患者的细胞病理学（TCT)结果和组织病理学（阴道镜组织活检）结果,并进行统计学分析。结果 10 111例患者中,910例TCT结果呈阳性,占9.00%。31~50岁所占比例最高（53.74%）。21~30、>60岁两个年龄组细胞学阳性各级别之间差异有统计学意义（P<0.05）。非典型鳞状细胞(atypical squamous cells,ASC）、低度鳞状上皮内病变（low grade squamous intraepithelial lesion,LSIL）与高度鳞状上皮内病变（high grade squamous intraepithelial lesion,HSIL）三组病例的平均年龄两两比较差异均有统计学意义（P<0.05）,且HSIL病例的平均年龄明显高于LSIL病例（P<0.05）。TCT检查阳性病例中,139例进行了病理组织活检,活检阳性病例为105例,细胞学阳性结果与组织病理学阳性诊断结果符合率为75.54%。病原体微生物检查中,以线索细胞感染为主。结论 宫颈液基细胞学检查对宫颈病变筛查有重要作用,宫颈病变发生及分布情况可为后期相关的研究做基础。

Thinprep cytologic test results and diagnosis analysis of 10 111 cases in Hebei

Objective To analyze the results of thinprep cytologic test (TCT) in 10 111 cervical women in outpatient clinic in Hebei. The occurrence and distribution of cervical lesions were observed. Methods Retrospective analysis was conducted on the data of 10 111 cases accepting TCT in Hebei General Hospital from December 5, 2016 to February 5, 2018, and the results were analyzed. The results of cytopathology and histopathology of the patients diagnosed as atypical squamous epithelial cells of the cervix (ASC-US) and above were statistically analyzed. Results The results of TCT showed that 910 patients were positive, accounting for 9.00%. Among all patients with positive cytology, the highest proportion was 31-50 years (53.74%). There was a statistically significant difference in the positive levels of cytology between the ages of 21 to 30 and >60 years old (P<0.05). The average age of each of the two groups were compared statistically significant in ASC, LSIL and HSIL groups (P<0.05). The average age of HSIL cases was significantly higher than that of LSIL cases (P<0.05). Of the positive cases of TCT examination, 139 cases underwent pathological biopsy, and 105 cases were positive for biopsy. The coincidence rate of positive cytology and histopathological diagnosis was 75.54%. In the pathogen microbiological examination, clue cells was the main factor. Conclusions Cervical cytological examination plays an important role in the screening of cervical lesions. The occurrence and distribution of cervical lesions can be the basis for later related studies.