单次液基细胞学检查对宫颈上皮内瘤变及宫颈癌的诊断价值

目的:评价采用TBS分类法的单次薄层液基细胞学(AutoCyte PREP)对C INⅡ以上病变的诊断价值。方法:回顾性分析2 198例行液基细胞学检查病人,细胞学结果大于或等于ASCUS者行阴道镜检查,并在阴道镜指导下进行活检,组织送病理学检查。并比较以不同细胞学结果为不同阴道镜检查起点时,其诊断C INⅡ以上病变的阳性预测值和阴道镜检率。结果:细胞学结果≥ASCUS者共587例,ASCUS、LSIL、HSIL、SCC组C INⅡ+的发生率分别为2.64%、8.46%、72.46%和100.00%。以ASCUS、LSIL、HSIL或SCC为阴道镜检查界点,阳性预测值和阴道镜检率分别为13.80%、26.70%;33.97%、9.50%;75.98%、3.59%和100.00%、0.45%。结论:单次薄层液基细胞学结果反映了宫颈上皮内瘤变及宫颈癌的分布,对C INⅡ+有良好的预测价值,且以LSIL为阴道镜检查起点最具诊断意义。

The diagnostic value of single liquid- based cytology for detection of histological confirmed CIN H or worse

Objective:To evaluate the diagnostic value of Single liquid-based Cytology(AutoCyte PREP) for detection of histological confirmed CIN Ⅱ+.Methods:A retrospective method was performed to analyze 2198 cases of cervical cancer screening.Cervical samples were collected into a liquid buffer and utilized for AutoCyte PREP cytological test.The patients whose cytological results were classified as ASCUS or above were instructed to do subsequent colposcopic biopsies.Then the positive predictive value and the percentage of colposcopic referral at different cytology threshold were compared.Results:There were 587 cases whose cytological resultswere or above ASCUS.The percentage of histological confirmed CIN II or worse in ASCUS,LSIL,HSIL or SCC was 2.64%,8.46%,72.46% and 100% respectively.The positive predictive value of detection of histological confirmed CIN II or worse and the colposcopic referral percentage at different cytology threshold were 13.80%,26.70%;33.97%,9.50%;75.98%,3.59% and 100%,0.45% respectively.Conclusion:The single AutoCyte PREP cytology results have good predictive value for detection of histological confirmed C1N II or worse.The best cytology threshold for colposcopic referral is LSIL.