TCT配合阴道镜在宫颈癌前病变筛查中的应用价值

目的探讨新柏氏液基薄层细胞学检测(TCT)配合阴道镜在宫颈病变筛查中的应用价值。方法2005年7月至2006年12月妇科门诊2311例进行TCT检查。结果异常者344例,宫颈病变检出率14.88%。宫颈上皮内病变及鳞癌共221例(9.56%),其中包括ASCUS162例(7.00%)、LSIL23例(0.99%)、HSIL34例(1.47%)、鳞癌2例(0.082%);HPV感染38例细胞检出率1.64%;良性病变85例,其中滴虫性阴道炎56例(2.42%)、霉菌性阴道炎29例(1.25%)。LSIL、HSIL、ASCUS在30～39岁组中发生率最高,40～49岁组为第二个高发阶段。对161例ASCUS及以上病变者进行阴道镜检查及活检,结果TCT细胞学与病理组织学诊断LSIL以上宫颈上皮内病变符合率为89.8%。结论TCT技术能明显提高异常细胞的检出率,因取材方便及无创,可作为宫颈癌前病变筛查的参考指标,阴道镜可确定宫颈病变的部位,提高宫颈活检的阳性率,故TCT配合阴道镜可作为宫颈癌前病变及早期癌筛查的可靠早期诊断方法。

Clinical Value of Thinprepcytologic Test(TCT) Combined with Vaginoscope in Screening of Cervical Precanoerou Lesions

Objective To investigate the application value of thinprepcytologic test(TCT) combined with vaginoscope in the screening of cervical precanoerou lesions(CIN).Method 311 suspicious patients were assigned to receive TCT combined with vaginoscope for all outpatients from June,2005 to Decemmber,2006.Results The abnormal patients were 344 cases,the detective rate of cervical lesions was 14.88%.Among them the cervical intraepithelial neoplasma and squamous carcinoma were 221 cases,including 162 cases(7.00%) of ASCUS,23 cases(0.99%) of LSIL,34 cases of HSIL and 2 cases of squamous carcinoma(0.082%);HPV infection were 38 cases(1.64%).85 cases were benign lesions,including 56 cases of trichomoniasis vaginitis(2.42%),29 cases of colpitis smycotica(1.25%).The women aged 30～49 years old were easily sufferred from cervical lesions.Age of 40～49 years was the second high period.Compared with vaginoscope biopsy for 161 cases,the coincidence rate on diagnosis of LSIL cervical lesions between TCT and pathologic examination of biopsy sample was 89.8%.Conclusions Adjunctive TCT can enhance the sensitivity and accuracy of the diagnosis of cervical leision by vaginoscopy and biopsy.Shortcut and cheap screening technique are still efficient important methods.Cytolopathology can localizte obviously elevate diagnostic accurcy of cervical biopsy.TCT combined with biopsy under colposcopy may be a reliable method to screening and early diagnosis of the precancerous lesions of uterine cervix cancer.