57372例液基宫颈脱落细胞学报告分析

目的:评价宫颈液基细胞学检查在宫颈癌筛查中的敏感性和价值,探讨宫颈病变的相关规律。方法:收集广东省妇幼保健院及广东省48个市县妇幼保健院门诊、住院患者送本院检测的宫颈液基细胞学标本57372例,采用TBS分级系统,意义不明确的非典型鳞状上皮细胞(ASC-US)以上病变为阳性病例,对其中细胞学结果阳性或阴性,但临床怀疑宫颈病变共计4214例,进一步行阴道镜及镜下取活检作组织病理学对照观察,对诊断结果进行比较分析。结果:57372例标本中,49052例(85.50%)未见上皮内病变或恶性病变(NILM),3870例(6.75%)非典型鳞状上皮细胞(ASC)、3862例(6.73%)低级别鳞状上皮内病变(LSIL)、470例(0.82%)高级别鳞状上皮内病变(HSIL)、32例(0.06%)鳞状细胞癌(SCC)、非典型腺上皮细胞(AGC)72例(0.13%)和腺癌(AC)14例(0.02%)。与病理组织学对照的4124例中,细胞学检出100.00%(46/46)鳞状细胞癌(SCC);100.00%(12/12)腺癌(AC);94.42%(372/394)高级别鳞状上皮内病变(HSIL);80.99%(1806/2230)低级别鳞状上皮内病变(LSIL)。CINⅠ、CINⅡ、CINⅢ、鳞癌和腺癌平均年龄分别是(33.30±13.28)岁、(35.30±7.83)岁、(72.25±7.61)岁、(45.61±6.73)岁和(42.67±10.13)岁。结论:宫颈病变,尤其是宫颈癌前病变的发病有年轻化趋势。液基细胞学能更有效地检出宫颈各类病变,结合阴道镜检查,更有助于预防宫颈癌的发病和降低宫颈癌的死亡率。

Analysis of 57 372 cases on cervical liquid cytology

Objective:To evaluate the sensitivity and clinical value of liquid-based cytology in the screening of cervical cancer,investigate the relative factors of cervical disease.Methods:57 372 cases of liquid-based cytology were collected and observed,when atypical squamous cell of undetermined significance (ASC-US) or above of the cases were diagnosed by cytology,they underwent biopsy of colposcopy and compared with the biopsy diagnosis.Results:Among the 57 372 cases,49 052 cases (85.5%) were negative for intraepithelial lesion or malignancy (NILM),3 848 cases (6.71%) were ASC,3 862 caes (6.73%) were low-grade intraepithelial lesion (LSIL),470 cases (0.82%) were high-grade intraepithelial lesion (HSIL),46 cases (0.09%) were squamous cell carcinoma (SCC),72 cases (0.13%) were atypical glandular cell of undetermined significance (AGC),6 cases (0.02%) were adenocarcinoma (AC).Compared with the biopsy,the cytology was able to detect 100% (46/46) of SCC,100% (6/6) of AC,94.42% (186/197) of HSIL and 80.99% (903/1 115) of LSIL.The average ages of CIN Ⅰ,C1N Ⅱ,CIN Ⅲ,SCC and AC were (33.30±13.28),(35.30±7.83),(72.25±7.61),(45.61±6.73) and (42.67±10.13) years.Conclusion:The cervical lesion,especially the precancer lesion is a younger tendency in age of occurrence of the disease. Liquid-based cytology can detect cervical lesion effectively,coped with colposcopy test,it can decrease the incidence rate and death rate of the cervical cancer.