液基超薄细胞检测结合TBS系统检测1583例宫颈涂片的临床分析

目的:对液基超薄细胞检测技术(thinprep cytologic test,TCT)和Bethesda系统(The Bethesda System,TBS)在宫颈病变诊断中的临床应用价值进行评价。方法:1583例门诊患者行TCT检查和TBS细胞学分类诊断,对TCT检查发现异常的患者进行阴道镜病理检查和PCR检测HPV-DNA。结果:1583例涂片中检出异常涂片241例,占15·22%。其中不典型鳞状细胞(ASCUS)88例(5·56%),低度鳞状上皮内病变(LSIL)45例(2·84%),高度鳞状上皮内病变(HSIL)8例(0·51%),鳞状细胞癌(SCC)1例(0·06%),子宫内膜腺癌1例(0·06%),HPV感染42例(2·65%)。TCT与阴道镜病理检查和PCR检测的符合率分别为83·82%、61·90%。结论:TCT技术应用于宫颈细胞涂片筛查,能明显提高涂片满意率及宫颈异常细胞检出率,减少漏诊率,TBS报告方法客观、准确、详尽,能及早发现宫颈早期病变。

The clinical analysis of 1 583 cervical smear cases using thinprep cytologic test and the Bethesda system

Objective:To evaluate the clinical value of thinprep cytologic test (TCT)and the Bethesda system (TBS) for the diagnosis of early cervical diseases.Methods:1 583 patients in this hospital have been examined by using TCT and TBS.The abnormal cases selected by TCT were detected by colposcopical pathological examination and human papillomavirus (HPV) test using polymerase chain reaction (PCR) technique.Results:241 (15.22%) abnormal smears out of 1 583 cases,in which atypical squamous cell of undetermined significance (ASCUS) 88 cases (5.56%),low grade squamous intraepithelial lesion (LSIL) 45 cases (2.84%),high grade squamous intraepithelial lesion (HSIL) 8 cases (0.51%),squamous cell carcinoma 1 case (0.06%),adenocarcinoma endometrium l case (0.06%),HPV infection 42 cases (2.65%).The rate of agreement compared with pathological results whereas was 83.82% and 61.90% compared with PCR results respectively.Conclusion:TCT can increase the satisfactory rate of smears as well as detection rate of abnormal cervical cells and decrease the rate of missed diagnosis.TBS is an objective, accurate and complete system.can detect cervical early disease as soon as possible.