TCT联合阴道镜LEEP刀在宫颈癌筛查诊治中的应用

目的探讨液基薄层细胞学检查(TCT)、阴道镜下宫颈病理活组织检查、宫颈环行电切术(LEEP)术的联合应用在宫颈病变诊治中的价值。方法回顾性分析承德市妇幼保健院妇产科患者共905例,对TCT、阴道镜下病理活组织检查及宫颈LEEP术联合应用结果的差异逐级进行比较分析,讨论其在宫颈病变诊治中的价值及意义。结果对于TCT提示异常者行宫颈活组织病理检查,两者的符合率分别为非典型鳞状细胞(ASC,包括ASC-US和ASC-H)ASC-US 60.00%、ASC-H 51.20%、鳞状上皮内低度病变(LSIL)40.25%、鳞状上皮内高度病变(HSIL)53.28%、鳞状细胞癌(SCC)66.67%。阴道镜下宫颈病理活组织检查与宫颈LEEP术结果的比较,宫颈上皮内瘤样病变(CIN)Ⅰ的符合率为60.71%;CINⅡ的符合率为63.27%;CINⅢ的符合率为73.81%;两者总的符合率为66.39%。结论宫颈TCT与阴道镜下活组织病理学检查及LEEP术联合应用能够明显提高宫颈癌前病变的诊断准确率。

The value of liquid thin-layer cytology examination (TCT) combined with colposcopic directed biopsy and loop electrosurgical excision procedure (LEEP) in the diagnosis of cervical lesions

Objective To explore the value of liquid thin-layer cytology examination (TCT) combined with colposcopic directed biopsy and loop electrosurgical excision procedure (LEEP) in the diagnosis and treatment of cervical lesions. Methods A total of 905 cases from obstetrics and gynecology department in Chengde Maternal and Child Care Service Centre were analyzed retrospectively. Compare the diagnostic effectiveness of various methods. Results The coincidence rates of TCT and biopsy were:ASCUS 60.00%,ASC-H 51.20%,LSIL 40.25%,HSIL 53.28%,SCC 66.67%. The coincidence rates of biopsy and LEEP were CINI 60.71%,CINII63.27%,CINIII 73.81%. Conclusion TCT screening combined with biopsy and LEEP can significantly increase the diagnostic accuracy.