宫颈癌筛查中液基细胞学研究

目的:评价液基细胞学(LPT)薄片制片对宫颈癌筛查的准确性。方法:对3600例和2200例受检者分别进行LPT制片和传统宫颈细胞涂片法进行宫颈癌筛查。细胞诊断采用TBS分级系统,阳性诊断包括意义不明的不典型鳞状上皮(ASCUS)以上病变。所有ASCUS以上病变的受检者全部在阴道镜下活检。结果:LPT薄片法和传统涂片法对ASCUS以上病变检出阳性率分别为10.5%和5.2%,两种检测方法的阳性率差异有统计学意义(P<0.01);两种制片方法的阳性结果与病理检查符合率比较:LPT薄片法检出SCC、HSIL、LSIL与阴道镜活检阳性符合率分别为100%、91%、82%,传统宫颈巴氏涂片法检出SCC、HSIL、LSIL与阴道镜活检阳性符合率分别为100%、60%、53%,两种方法比较差异有统计学意义(P<0.05)。结论:LPT液基细胞学检查敏感性明显高于传统宫颈细胞涂片法,能大大提高检出率,尤其是对宫颈癌前筛查的患者。

Analysis on liquid-based cytology test in the screening of cervical cancer

Objective: To evaluate the accuracy of liquid-based cytology test in the screening of cervical cancer. Methods: 3 600 and 2 200 subjects were screened for cervical cancer by liquid-based cytology test and traditional cervical cells smears, respectively. Cell diagnosis adopted TBS-group system, positive diagnosis included above-ASCUS pathological changes. All the subjects of above-ASCUS pathological changes were examined under colposcopo. Results: The detection rates of above-ASCUS pathological changes identified by liq-uid-based cytology test and traditional smears were 10. 5% and 5.2 %, respectively (P < 0. 01) . The coincidence rates of SCC, HSIL and LSIL detected by liquid-based cytology test and biopsy under eolposcepe were 100%, 91% and 82%, respectively, while the coinci-dence rates detected by traditional cervical cells smears and biopsy under colposcope were 100%, 60% and 53%, respectively (P <0. 05)Conclusion: The sensitivity and detection rate of liquid-based cytology test are higher than those of traditional cervical cells smears, es-pecially for pre-screening of cervical cancer.