液基细胞学在宫颈病变筛查中的临床价值

目的:评价液基细胞学(thinprep cytologic test,TCT)在宫颈病变筛查中的准确性。方法:回顾性分析武汉市中心医院2008年7月～2010年5月宫颈TCT筛查与宫颈活检结果603例。结果:30～49岁年龄段患者381例(63.18%),细胞学结果在正常、LSIL、HSIL中与组织学结果符合率分别为90.76%、11.54%、60.00%,TCT诊断准确性为88.89%,敏感性为66.00%,特异性为95.43%。不典型上皮内瘤变(atypical squamous cells,ASC)378例对应组织学结果分别为正常285例,宫颈上皮内瘤变(cervical intraepithelialneoplasia,CIN)Ⅰ25例,CINⅡ～Ⅲ65例,宫颈鳞状上皮细胞癌(squamous cellcarcinoma,SCC)3例。P16与Ki-67阳性率在组织学结果为正常或炎症,CINⅠ与CINⅡ～Ⅲ分别为50.00%,60.00%,100.00%和67.00%,80.00%,100.00%。结论:TCT是一种准确性高的筛查方法,对临床医生分析宫颈病变有指导意义。

Clinical value of liquid-based cytology in screening of cervical lesions

Objective:To evaluate the accuracy of thinprep cytological test(TCT) in screening of cervical lesions. Methods:The results of cervical screening with TCT and cervical biopsy of 603 cases in Central Hospital of Wuhan city from July 2008 to May 2010 were analyzed retrospectively. Results:The ages of 381 cases(63.18%) were 30-49 years,the coincidence rates of normal cervical tissue,low-grade squamous intraepithelial lesion(LSIL),and high-grade squamous intraepithelial lesion(HSIL) between cytological results and histological results were 90.76%,11.54%,and 60.00%,respectively;the accuracy,sensitivity,and specificity of TCT were 88.89%,66.00%,and 95.43%,respectively.Among 378 cases with atypical intraepithelial neoplasia,285 cases were found with normal results,25 cases were found with cervical intraepithelial neoplasia(CIN) I,65 cases were found with CIN Ⅱ-Ⅲ,and 3 cases were found with squamous cell carcinoma by histological test.The positive rates of P16 and Ki-67 in the cases whose histological results were normal cervical tissue or inflammation,CIN I,and CIN Ⅱ-Ⅲ were 50.00%,60.00%,100.00% and 67.00%,80.00%,100.00%,respectively. Conclusion:TCT is a screening method with high accuracy,which has an instructional significance for clinicians to analyze cervical lesions.