液基细胞学检查联合阴道镜宫颈活检在宫颈病变诊断中的应用价值

目的:探讨液基细胞学检查(TCT)诊断配合阴道镜宫颈活检对宫颈上皮内瘤样病变(CIN)的诊断价值。方法:对165例行TCT筛查阳性患者行阴道镜宫颈活检,采用TBS分级系统进行诊断,并与病理结果进行比较。结果:123例经TCT诊断为ASCUS患者中,诊断为CIN 61例,与阴道镜宫颈活检符合率为49.6%(CINⅠ50例,CINⅡ8例,CINⅢ3例);29例LTC诊断为HSIL患者中,诊断为CIN21例,与阴道镜宫颈活检符合率为72.4%(CINⅠ11例,CINⅡ8例,CINⅢ2例);12例TCT诊断为LSIL患者中,诊断为CIN 8例,与阴道镜宫颈活检符合率为66.7%(CINⅠ5例,CINⅡ2例,CINⅢ1例);TCT诊断为SCC的1例患者,诊断为浸润癌,与阴道镜宫颈活检符合率为100.0%。结论:TCT配合阴道镜宫颈活检诊断宫颈病可以降低漏诊率,是宫颈癌前病变简单有效的诊断方法,值得临床推广应用。

Application value of liquid-based cytology test combined with colposcopic cervical biopsy for diagnosis of cerivical intraepithelial neoplasia

Objective: To study the value of liquid-based cytology(TCT) test combined with colposcopic cervical biopsy for diagnosis of cerivical intraepithelial neoplasia(CIN).Methods: Among 165 cases that underwent regular TCT test screening up,those who were diagnosed as positive underwent colposcopic cervical biopsy for further diagnosis by TBS classification system,and the TCT test results were compared with colposcopic cervical biopsy results.Results: Sixty-one of the 123 cases that were diagnosed as ASCUS were diagnosed as CIN,showing accuracy rate of 49.6% according to colposcopic cervical biopsy results(50 cases CINⅠ,8 cases CINⅡ and 3 cases CINⅢ);of the 29 cases that were diagnosed as HSIL according to TCT,21 cases were diagnosed as CIN,showing accuracy rate of 72.4% according to colposcopic cervical biopsy results(11 cases CINⅠ,8 cases CINⅡ and 2 cases CINⅢ);of the 12 cases that were diagnosed as LSIT according to TCT 8 were diagnosed as CIN,showing accuracy rate of 72.4% according to colposcopic cervical biopsy results,0ne case was diagnosed as SCC,which is confirmed by colposcopic cervical biopsy results.Conclusion: The liquid-based cytology test combined with colposcopic cervical biopsy can avoid misdiagnosis,it is a simple and effective diagnostic method for the cervical precancerous lesions,and is worthy of clinical application.