宫颈液基薄层细胞学检查与组织病理学诊断结果对比研究

目的探讨液基薄层细胞学检查（TCT）宫颈病变筛查中的应用价值。方法回顾性分析2010年5月～2011年8月2 238例女性患者的TCT结果,结果异常者行组织病理学检查,比较TCT与组织病理学检查的诊断情况。结果 TCT诊断慢性宫颈炎322例;不明确意义的不典型鳞状上皮细胞（ASC-US）以上病变157例,其中ASC-US 71例,不除外上皮内高度病变的不典型鳞状细胞（ASC-H）14例,低度鳞状上皮内病变（LSIL）47例,高度鳞状上皮内病变（HSIL）23例,鳞状细胞癌（SCC）2例。TCT诊断慢性宫颈炎与组织病理学诊断符合率较高（98.14%,316/322）,6例病理诊断提示存在上皮内瘤变（CIN）。TCT示LSIL以上阳性率为49.04%,与组织病理学阳性率（50.96%）比较,差异无统计学意义（P〉0.05）。TCT对SCC和HSIL的诊断符合率较高,分别为100.00%、69.57%,LSIL诊断符合率较低,为40.43%,HSIL诊断符合率显著高于LSIL,差异有统计学意义（P〈0.05）。结论 TCT检查能够提高宫颈癌前病变,尤其是高度癌前病变的检出率,减少误漏诊。TCT与组织病理学检查相互补充,是筛查和诊断宫颈病变的有效方法。

Comparative study of liquid-based thin-layer cytology technique and histopathology in the diagnosis of cervical lesions

Objective To investigate the value of liquid-based thin-layer cytology technique（TCT） in the diagnosis of cervical lesions.Methods TCT results of 2 238 female patients from May 2010 to August 2011 were retrospectively analyzed,patients with abnormal TCT findings underwent histopathology,and the diagnosis of two methods were compared.Results 322 cases of chronic cervicitis were found by TCT;157 cases above ASC-US were found,including 71 cases of ASC-US,14 cases of ASC-H,47 cases of LSIL,23 cases of HSIL,2 cases of SCC.The diagnose accordance rate of TCT and histopathology in chronic cervicitis was 98.14%（316/322）,6 cases with CIN were confirmed by histopathology.The positive rate above LSIL was 49.04% by TCT,the difference compared with histopathology positive rate（50.96%） was not statistically significant（P〉0.05）.The diagnose accordance rates for SCC and HSIL by TCT were 100.00% and 69.57% respectively,which were higher than those of LSIL（40.43%）,the differences were statistically significant（P〈0.05）.Conclusion TCT can improve the detection rate of CIN,especially highly CIN,and decrease misdiagnosis.TCT and histopathology are mutually complementary,thus they are effective methods for screening and diagnose cervical lesions.