宫颈液基细胞学与组织学误差原因对比分析

目的:探讨液基细胞学(LCT)在妇科病人人群中宫颈病变的准确性,评价LCT在子宫颈癌早期诊断中的价值.方法:对15274例LCT中有活组织检查对照的794例进行回顾性分析.结果:LCT LSIL以上病变的阳性率35.7%(284/794),活检CIN Ⅰ以上病变阳性率41.8%(332/794),两者统计学比较无明显差异(P＞0.05),LCT的假阴性(漏诊)率分别为LSIL31.9%(53/158)、HSIL17.5%(21/120)、SCC15.4%(6/39)、AC50%(1/2).假阳性(误诊)率分别为LSIL22.9%(41/179)、HSIL5.2%(5/96)、SCC0.0%(0/6)、AC0.0%(0/1).结论:液基细胞学检查是宫颈癌及癌前病变筛查的有效手段,但也有其局限性,获取满意的宫颈细胞标本对提高诊断准确性有重要意义,阴道镜检查及宫颈多点活检可弥补液基细胞学检查假阴性的疏漏.而对LSIL及以上病变由两位病理医生按诊断标准共同诊断是避免假阳性的主要措施.

Comparative analysis on causes of errors between cervical LCT and histology

Objective To explore the accuracy of LCT in cervical lesion and evaluate the value of LCT in early diagnosis of cervical carcinoma. Methods Of 15274 cases, 794 cases with biopsy were retrospectively analyzed. Results There was no difference between positive percentage above LCT LSIL and CINI (p>0.05). False-negative percentage of LCT was LSIL31.9%, HSIL17.5%, SCC15.4%, AC50%. False-positive percentage of LCT was LSIL22.9%, HSIL5.2%, SCC0.0%, AC0.0%. Conclusion LCT is an effective means of screening cervical carcinoma and pre-cancer change. It is necessary to obtain satisfactory cervical cell sample for diagnosis and cervical biopsy can retrieve false-negative of LCT.