液基薄层细胞学检测对宫颈癌筛查的临床研究

目的：分析妇女宫颈疾病患病情况，对液基超薄细胞检测及Bethesdas(TBS)细胞学分类法在宫颈癌筛查中的应用价值进行综合评价。方法：对妇科门诊2600例患者行液基超薄细胞检测，采用TBS分类法，按年龄分为6个组，其中205例上皮异常者进行阴道镜检查和活检作病理诊断对照，随访6～18个月。结果：鳞状上皮异常者共409例(15．73％)。其中未明确诊断意义的鳞状细胞(ASCUS)167例，未明确诊断意义的腺细胞(AGUS)2例：低度鳞状上皮内病变(LSIL)210例，高度鳞状上皮内病变(HSIL)28例，鳞状细胞癌(SCC)2例。205例上皮异常者行阴道镜下活检。细胞学诊断鳞状上皮内病变(SIL)114例，检出率4．38％，组织病理学检出鳞状上皮内病变(CIN)117例，检出率3．73％。细胞学与组织学诊断符合率为89．21％。结论：宫颈疾病患病年龄趋于年轻化。TCT技术应用于宫颈癌筛查能明显提高宫颈异常细胞检率。TBS报告方法直观、具体，便于临床与细胞学医生之间的沟通；不典型上皮细胞根据个体情况观察4～6个月或进行阴道镜下检查，而HPV阳性者立即行阴道镜下活检。

The Clinical Study of Thinprep Cytology Test in Screening Cervical Cancer

Objective:To analyse the female cervical diseases and comprehensively evaluate the application of Thinprep cytology test(TCT)and Bethesdas cytological system(TBS)in screening of cervical cancer.Method:TCT were conducted in 2600 out-patients of gynecology in our hospital,and the results were analysed by Betheda diagnostic criteria.The patients were divided into 6 groups according to ages for observation and comparison.And they were followed up for 6-18 months.Results:409 cases with abnormal squamous epithelium (15.73%) included 167 cases with ASCUS(atipical spuamous cells of undertermined significance),2 cases with AGUS(atipical glandular cells of undertermined significance),210 cases with LSIL(low-grade squamous intraepithelial lesion),28 cases with HSIL(high-grade squamous intraepithelial lesion)and 2 cases with SCC(squamous carcinoma).Biopsy was conducted in 205 cases with abnormal epithelium.Cytology test detected SIL in 114 cases with the detecting rate of 4.38%.Histopathological test detected CIN in 117 cases with the detecting rate of 3.73%.The coincident rate of the diagnosis of TCT cytology and histology was 89.21%.Conclusion:The age of cervical diseases tends to be younger.TCT applying in screening cervical cancer can elevate the detecting rate of cervical abnormal cells.TBS is direct and concrete,facilitating the communication between the clinical doctors and cytologist.The patients with atypical epithelial cells should be observed for 4 to 6 months or conducted biopsy under colposcopy.