宫颈薄层液基细胞学上皮细胞异常与宫颈活检病理分析

目的分析宫颈薄层液基细胞学上皮细胞异常与宫颈活检组织病理学诊断的符合率及对子宫颈病变的诊断价值。方法通过对本院妇产科2008年8月-2011年4月的2052例患者做薄层液基细胞学检测,TBS报告方式进行宫颈细胞学检查。对诊断意义不明的不典型鳞状细胞（ASC—US）以上患者231例,在阴道镜下做宫颈活检,将其结果作对照回顾性分析。结果宫颈薄层液基细胞学检测结果显示：不典型鳞状上皮细胞（ASC—H）检出率为7．21％,低度鳞状上皮内病变（L—SIL）检出率为1．21％,高度鳞状上皮内病变（H—SIL）检出率为0．19％。阴道镜下宫颈活检病理诊断符合率分别为ASC—H85．4％、L—SIL92．0％、H—SIL100％。结论液基细胞学与病理组织学有较高的符合率,对高级别CIN和宫颈癌诊断准确率高,配合阴道镜病理活检能及早发现CINⅢ级或原位癌,宫颈薄层液基细胞学检测结果诊断为宫颈上皮异常,均应做宫颈活检．以防漏诊。

The analysis of the thinprep cytology test epithelial cell abnormalities and the cervical biopsy

Objective To analyse the diagnose accordance rate between the abnormal epithelial cells by TCT and the cervical biopsy, and the diagnostic value of cervical lesion. Methods Examination results of 2 052 cases who were received TCT and the TBS reporting cervical cytology in the Obstetrics and Gynecology outpatient clinic of our hospital from Aug 2008 to Apr 2011. 231 cases with ASC-US, confirmed the cervical biopsy through colpomieroscope. Retrospective analysis of the control line was conducted. Results The thinprep cytology test showed： ASC-H（7.21%）, L-SIL（1.21%）, H-SIL（0.19%）. The diagnose accordance rate by cervical biopsy was ASC-H（84.5%）, L-SIL（92.0%）, H-SIL（100%）. Conclusion The diagnose accordance rate of the thinprep cytology test, which shows a high rate of accuracy for high level CIN and cervical cancer diagnose, is well consistent with histopathology. Each case diagnosed as CIN by the thinprep cytology test should be diagnosed by biopsy, to avoid misdiagnosis, so that CIN Ⅲ or carcinoma in situ will be diagnosed in time.