液基细胞学联合阴道镜检查在诊断子宫颈病变中的临床应用

目的:提高早期子宫颈病变的诊断。方法:选择北京安贞医院门诊行液基细胞学(TCT)检查3084例,对其中146例细胞学阳性病例行阴道镜检查及镜下活组织病理检查。结果:行TCT检查3084例,细胞学阳性146例,占4·73%,其中不典型鳞状上皮细胞(ASCUS)74例(2·40%)、低度鳞状上皮内病变(LSIL)57例(1·85%)、高度鳞状上皮内病变(HSIL)15例(0·49%)。对所有细胞学阳性病例均行阴道镜检查及镜下活组织病理检查。异常阴道镜图像110例(75·30%)。与病理组织学对照,ASCUS(CINⅠ34例、CINⅡ10例、CINⅢ3例);LSIL(CINⅠ25例、CINⅡ18例、CINⅢ4例、SCC1例);HSIL(CINⅡ4例、CINⅢ10例、SCC1例)。结论:应用TCT筛查子宫颈病变,细胞学阳性病例联合阴道镜检查及镜下活组织病理检查,能早期发现癌前病变,防治宫颈癌。

Clinical application of TCT technique combined vaginoscopy in diagnosing uterocervieal disease

Objective:To improve the early diagnosis efficiency of uterocervical disease in the clinic.Methods:3 084 cases examined with ThinPrep Cytology Test (TCT) technique were selected by random.Among of them, 146 positive cases in the cytologic diagnosis were examined by vaginoscopy and pathologic biopsy.Results:Among all the 3 084 cases examined with TCT technique, 146 cases were positive of the cytologic diagnosis (4.73%) to be further analyzed with cell pathology, vaginoscopy and pathologic biopsy, and to be divided into the following subsets: 74 cases for atypical squamous cells (ASCUS, 2.4%), 57 cases for low grade squamous intraepithelial lesion (LSIL, 1.85%), 15 cases for high grade squamous intraepithelial lesion (HSIL, 1.85%).110 cases were abnormal in the vaginoscopy images. Compared with the result obtained from the pathologic diagnosis, 74 cases for AUCUS (CIN Ⅰ 34 cases, CIN Ⅱ 10 cases, CIN Ⅲ 3 cases); 57 cases for LSIL (CIN Ⅰ 25 cases, CIN Ⅱ 18 cases, CIN Ⅲ 4 cases, SCC 1 case); 15 cases for HSIL (CIN Ⅱ 4 cases, CIN Ⅲ 10 cases, SCC 1 case).Conclusion:TCT technique is necessary for screening uterocervical disease.Cytologic diagnosis combined with vaginoscopy and pathologic biopsy can contribute to both the early discovery of intraepithelial neoplasia and prevention of uterocervical cancer.