九江地区9328例宫颈液基细胞学检查结果分析

目的了解九江地区妇女宫颈癌及癌前病变的状况,探讨液基薄层细胞涂片（liquid-based cytology test,LBC）检查及阴道分泌物人乳头瘤病毒（human papilloma virus,HPV）16,18的感染状态检查对早期宫颈癌及癌前病变诊断的临床意义。方法对九江学院附属医院妇科门诊就诊者9 328例进行LBC检查,对其中1 211例患者进行阴道分泌物HPV16,18 DNA检查并对阴道镜宫颈活检病理结果进行研究。结果 LBC阳性病例1 008例中有890例进行了活检,另有接触性阴道出血或不规则阴道流血而LBC阴性病例70例进行了阴道镜下活检,共计960例病理检查结果：正常或慢性炎症807例（84.06%）,宫颈上皮内瘤变（cervical intra-epithelial neoplasia,CIN）I级61例（6.35%）,CINⅡ级22例（2.29%）,CINⅢ级25例（2.60%）,宫颈癌45例（4.69%）。9 328例患者中,宫颈癌、CINⅢ、CINⅡ、CIN I检出率分别为0.48%、0.27%、0.24%、0.65%。1 211例患者行阴道分泌物HPV16,18 DNA检查,HPV16,18阳性214例（17.67%）。结论 LBC检查是一种相对准确、可靠的宫颈病变筛查方法,但是仍然有一定的漏检率。如果能结合HPV16,18的检查,可以减少假阴性率,减少漏诊。

Clinical analysis of cervical liquid - based cytology detecting in 9 328 cases in Jiujiang area

Objective To understand the condition of cervical cancer and precancerous lesions in Jiujiang area, to investigate the clinical significance of liquid - based cytology （ LBC ） examination and vaginal secretions of human papilloma virus（HPV） 16, 18 infection status on the early cervical cancer and precancerous lesions diagnosis. Methods 9 328 cases were examined by LBC in gynecology clinic that affiliated hospital of Jiujiang college, 1 211 cases were examined with vaginal secretions which to check whether the patients had HPV16and 18DNA, to research the colposcopy results of cervical biopsy by vaginoscope. Results 890 cases were biopsied in 1 008 LBC - positive cases, in addition, 70 cases were underwent vaginoseope biopsied who were vaginal bleeding for contacting or irregular vaginal bleeding while they were LBC negative cases, with 960 cases pathological findings in total ： normal or chronic inflammation in 807 cases （ 84. 06% ） ; cervical intra - epithelial neoplasia （ CIN ） Ⅰ grade in 61 cases （6. 35% ） ;CINⅡ grade in 22 cases （2. 29% ） ; CINⅢ grade in 25 cases （2. 60% ） ; cervical cancer in 45 cases （4.69%）. The detection rates of cervical cancer CINⅢ, CINⅡ, CINI were 0. 48% , 0. 27% , 0.24% , 0. 65% in 9 328 cases. 1 211 cases with vaginal secretions HPV16,18 DNA examination, HPV 16,18 positive in 214 cases （17.67%）. Conclusion LBC examination is a relatively accurate and reliable screening method for cervical lesions, but it still has some leakage detection rates. If combined with HPV 16,18 examination, false negative rates and misdiagnosis can be reduced.