TCT、阴道镜下活体组织活检在宫颈疾病筛查中的临床应用

目的 探讨薄层液基细胞学（TCT）、阴道镜下活体组织活检（活检）在宫颈疾病筛查中的临床应用.方法 收集2011年1～12月在我院妇科门诊行TCT检查者共6 835例,且对选择TCT异常并同时行阴道镜下活检的269例患者资料进行了回顾性分析.结果 在实施TCT检查的6 835例中,发现细胞学异常476例（约占6.96%）,其中ASC-US 338例（占4.95%）,ASC-H 16例（占0.23%）,LSIL 79例（占1.16%）,HSIL 35例（占0.51%）,AGC 8例（占0.12%）.施行阴道镜下活检患者269例,组织学CIN检出率114例（42.38%）,而CINⅡ及更高级宫颈病变检出率ASC-U为6例（4.35%）,ASC-H为9例（56.25%）,LSIL为11例（12.3%）,HSIL为23例（65.71%）;其中浸润癌3例（8.57%）,AGC 3例（37.50%）,1例腺癌（12.50%）.结论 TCT作为初筛手段是高效的,但须经阴道镜检查验证宫颈病变是否存在,并需在其指引下取宫颈组织活检确诊.

TCT, living tissue biopsy under colposcope in screening of cervical diseases and its clinical application

Objective To explore the TCT, the colposcopic biopsy （biopsy） in cervical disease screening clinical ap- plication. Methods Collected from January 2011 to December of 6 835 cases in our hospital gynecology clinic line TCT examination and selection TCT exception while line 269 colposcopic biopsy patients were retrospectively ana- lyzed. Results Checked the implementation of TCT 6835 cases found cytological abnormalities 476 cases. 269 cases of applying colposcopic biopsy patients, Histological CIN detection rate of 114 cases, CIN H and more advanced cervical lesion detection rate ASC-U 6 cases, ASC-H for 9 cases, LSIL 11 cases, HSIL 23 cases. Conclusion TCT efficient as a primary screening, but shall be subject to verification of colposcopy cervical lesions exists, and the need to take cer- vical biopsy-confirmed.