薄层液基细胞学在宫颈病变筛查中的应用

目的探讨薄层液基细胞学检测技术在宫颈病变筛查中的应用价值。方法回顾性分析2007年3～7月间南京军区杭州疗养院妇科体检中3580例ThinPrep液基细胞学检查结果,并对上皮细胞异常者进行随访以获得组织学病理结果,然后行对照相关性分析。结果上皮细胞异常者190例,占5.31%,包括ASC-US102例(2.85%),ASC-H5例(0.14%),LSIL69例(1.93%),HSIL14例(0.39%)。通过随访获得167例阴道镜病理组织学结果,细胞学与组织学的诊断符合率为76.1%,细胞学为ASC-US者中有32.9%经病理证实为CIN。相关性分析提示TCT结果异常者检出CIN的风险(RR)远高于普通人群。组间比较得出,ASC-US组与LSIL组检出CINⅡ、CINⅢ/CIS的RR值差异没有统计学意义(P=0.26,0.76),ASC-US组与HSIL组检出CINⅠ的RR值差异也没有统计学意义(P=0.91),其他组间比较的差异均存在统计学意义(P0.05,数据未显示)。结论TCT技术应用于宫颈病变筛查,能有效提高宫颈癌前病变及宫颈癌的检出率,且结果与病理组织学对照符合率较高,是宫颈病变筛查的有效方法。对细胞学诊断为ASC-US者应予重视,及时进行高危型HPV检测,必要时进行阴道镜检查。

Liquid-based cytology thinprep cytologic test in screening of intraepithelial neoplasia

Objective To study the value of ThinPrep cytology test （TCT） in screening cervical intraepithelial lesion.Methods Examinination results of 3 580 cases who were received TCT in health examination in Hangzhou sanatorium ,Nanjing Military Command from March to July,2007 were retrospectively analyzed.The cases with abnormal result were followed up and confirmed by histopathologic examination.Correlation analysis was conducted.Results The results of TCT demonstrated that there were 190 cases with abnormal epithelial cells among 3 580 cases（5.31%）,including 102 cases of ASC-US （2.85%）,5 cases of ASC-H （0.14%）,69 cases of LSIL（1.93%）and 14 cases of HSIL（0.39%）.167 cases were received further pathological examination by colpomicroscope. The diagnose accordance rate of cytological and pathological examination was 76.1%.32.9% people with ASC-US were confirmed for C1N.The correlative analysis indicated that the risk ratio for detecting C1N in groups with abnormal epithelial cells confirmed by TCT was dramatically higher than that in common cases （P 〈 0.05）.There was no significant difference of the risk ratio for detecting CINII and CINIII/CIS between ASC-US and LSIL group （P=-0.26,0.76）.The same as the risk ratio for detectingCINI between ASC-US and HSIL group（P=-0.91）,whereas there was statistical significance between other groups（P〈 0.05）.Conclusion Application of TCT in screening cervical intraepithelial lesion can effectively improve the detection ratio of cervical precancerosis as well as cer- viral cancer,and the diagnose accordance rate of TCT and pathological examination was relatively high, indicating TCT is an effec- tive method for screening C1N.People with ASC-US should be focused and detected for high risk-HPV,and even received colposcopy examination if necessary.