新柏氏液基细胞学在门诊宫颈癌筛查中的应用

目的通过对宫颈液基薄层细胞学(TCT)检查结果的分析,探讨TCT在妇科门诊宫颈癌筛查中的应用价值。方法对2002年7月至2005年6月3年间14160例门诊患者行TCT检查结果进行回顾性分析。14160例TCT中,宫颈阴道细胞学正常11582例(81.79%),且逐年下降,阴道重度炎症者1071例(7.56%),宫颈鳞状上皮内低度瘤样病变LSIL(CIN1)294例(2.08%),呈上升趋势,分别为1.23%,1.22%,3.48%。宫颈鳞状上皮内高度瘤样病变HSIL(CIN2/3)99例(0.7%),发病率有上升趋势,分别为0.84%,0.55%,0.9%。宫颈鳞癌16例(0.11%),宫颈腺癌3例(0.02%),不典型鳞状细胞(ASCUS)866例(6.12%),3年间发病率逐年升高,分别为1.83%,3.54%,11.57%。人乳头瘤病毒感染(HPV)108例(0.76%),发病率分别为0.99%,0.4%,0.94%;HPV感染在LSIL(CIN1)中占30.59%,在HSIL(CIN2/3)中为11.93%。CIN1,CIN2/3,ASCUS及HPV的高发年龄段均为20～30岁。结论新柏氏TCT系统可提高门诊宫颈癌及癌前病变的检出率。值得担忧的是20～30岁为宫颈癌前病变的高发年龄段,应密切监测。降低HPV感染,治疗并阻止CIN病变升级,是降低宫颈癌发病率的重要环节。HPV感染是CIN的重要相关因素。

Clinical application of thinprep cytological test (TCT).In screening cervical carcinoma

Objective To evaluate the clinical significance of thinprep cytological technique in screening cervical carcinoma with analysis of the examination results of thinprep cytological technique.Methods Retrospectively study the results of thinprep cytological test of 14160 patients during July 2002 from June 2005 in our hospital.Results Among the 14160 cases,11582（81.79%） were WNL,severe infection was 1071（7.56%）,LSIL（CIN1） was 294（2.08%）,meanwhile the incidence rate increased from during the study period.HSIL（CIN2/3） was 99（0.7 %）,and the incidence rate had been increasing during the period as well.Squmaous cell carcinoma was 16（0.11%）,Glandular cell carcinoma 3（0.02%）,866（6.12%） were ASCUS,and the incidence rate increased from during the study period.But 108（0.76%） were HPV positive,this incidence increased obviously during the three years.HPV positive in CIN1 was 30.59%,but it was only 11.93% in CIN2/3.The high-incidence age of cervical cancer precursor lesions（CIN1,CIN2/3,ASCUS and HPV） were around 20～30 years old.Conclusion Thinprep cytology can significantly increase the sensitivity and accuracy for detecting cervical lesions.The ratio of the WNL should be monitored regularly,as 20～30 years old women are suffering high risks of cervical cancer precursor lesions.Reducing and avoiding the incidence of the HPV infection and CIN progressioncould could be recognized as an important section in decreasing the incidence rate of cervical carcinoma.While,the HPV infection is definitely related to the CIN.