15564例宫颈细胞学诊治结果分析

目的:评价宫颈异常细胞学的诊治结局,为临床正确处理提供参考。方法:对15 564例薄层液基细胞学(TCT)报告为异常的1 090例和TCT提示正常或炎症需进行宫颈微波治疗的1 277例进行阴道镜检查,并对诊治结局进行回顾性分析。结果:15 564例共检出ASCUS 716例(4.60%),AGC10例(0.06%),ASC-H 8例(0.05%),LSIL 269例(1.73%),HSIL 71例(0.46%),宫颈癌16例(0.10%);对活检确诊的437例C IN行LEEP术,手术前后病理诊断符合率为40.73%,术后病理级别下降者占42.56%,术后病理级别上升者占16.71%。结论:TCT是宫颈病变初筛的重要方法,结合阴道镜活检可早期发现宫颈癌前病变;LEEP术是明确诊断和治疗C IN有效而理想的方法,阴道镜点活切有一定的局限性,术后仍应严密随访。

Analysis on results of diagnosis and treatment of cervical cytology in 15 564 cases

Objective:To evaluate the results of diagnosis and treatment of abnormal cytology of cervix,provide some references for clinical appropriate management.Methods:15 564 cases were detected by liquid-based thinprep cytology test(TCT),1 090 cases with abnormal results and 1 277 cases undergoing microwave therapy were examined by vaginoscopy,then the results were analysed retrospectively.Results:Among the 15 564 cases,there were 716 cases(4.60%) of ASCUS,10 cases(0.06%) of AGC,8 cases(0.05%) of ASC-H,269 cases(1.73%) of LSIL,71 cases(0.46%) of HSIL and 16 cases(0.10%) of cervical cancer;437 cases of CIN underwent LEEP,the coincidence rate before and after operation was 40.73%,the proportions of downgraded cases and upgraded cases were 42.56% and 16.71%.Conclusion:TCT is a vital method for cervical cancer screening,which can be adopted combined with biopsy under vaginoscopy to detect precancerous lesions of uterine cervix;TCT is a effective and perfect method for the specific diagnosis and treatment of CIN,biopsy under vaginoscopy has some limitations in the diagnosis of cervical disease,regular follow-up is necessary.