薄层液基细胞学技术对宫颈疾病诊断价值评价

目的评价薄层液基细胞学检测方法(TCT)对宫颈疾病的诊断价值。方法收集2006年1-12月在山西医科大学第二医院妇科住院病人的资料,选择做过TCT检查并追踪到有确切组织病理学诊断结果的462例病例为研究对象,以病理学诊断结果为金标准,评价TCT检测的诊断价值。结果462例住院病人中,经TCT检出宫颈鳞状细胞癌(SCC)和腺癌(AC)19例、鳞状上皮内高度病变(HSIL)28例、鳞状上皮内低度病变(LSIL)15例、意义不明的不典型鳞状细胞(ASC-US)和腺细胞(AGUS)35例、正常(WNL)365例。以病理学诊断结果为金标准,TCT检测的灵敏度为94.7%,特异度93.8%,约登指数为0.885,阳性似然比15.27,阴性似然比0.06,总符合率为93.7%,Kappa值0.79,阳性预测值74.2%,阴性预测值98.5%。TCT与组织病理学诊断结果的阳性符合率在宫颈癌中为95.0%,在HSIL、LSIL中分别为82.4%和68.2%。TCT检测对宫颈癌和HSIL的阳性符合率高于LSIL(P<0.05)。结论TCT检测对宫颈病变的诊断价值较高,特别是对宫颈癌和HSIL。

Evaluation of ThinPrep Cytology Test in Cervical Pathologic Alteration

Objective To study the efficacy of ThinPrep cytology test(TCT)in cervical lesions.Methods The clinical data of 462 gynecologic inpatients diagnosed by both TCT and histopathology were collected in the Second Hospital of Shanxi Medical University from Jan.2006 to Oct.2006.Histopathological results were used as gold standard to calculate the indices of diagnostic effectiveness evaluation of TCT technique.Results A total of 462 cases were detected by TCT,and the testing results showed 19 cervical cancer,28 HSIL,15 LSIL,35 ASC-US and AUGS,and 365 cases within normal limits(WNL).The sensitivity and specificity of TCT was 94.7% and 93.8% respectively.The Youden's index was 0.885.Positive likelihood ratio was 15.27,while negative likelihood ratio was 0.06.The consistency rate was 93.7%.Kappa value was 0.79.Positive predictive value was 74.2%,while negative predictive value was 98.5%.The positive consistency rate of TCT and histopathology diagnosis was 95.0% in cervical cancer,82.4% in HSIL and 68.2% in LSIL.Chi square test displayed the diagnosis of cervical cancer and HSIL was better than that of LSIL significantly among TCT and pathologic histology(P < 0.05).Conclusions:The TCT technique shows highly diagnostic efficacy,it is an efficient diagnostic test for CIN and cervical cancer.