宫颈液基薄层细胞学检测（TCT）联合阴道镜在筛查宫颈癌前病变中的价值

目的 探讨宫颈液基薄层细胞学检测（Thinprep cytologic test,TCT）联合阴道镜在筛查宫颈癌前病变中的诊断价值.方法 选择2006年6月至2011年7月在本院妇科门诊采用TCT和阴道镜检查筛查宫颈癌前病变的患者982例,同时在阴道镜下对患者宫颈进行多位点活检送病理检查.以组织病理学检查为金标准,分析TCT和阴道镜在筛查宫颈癌前病变中的诊断价值.结果 在982例妇女中,TCT细胞学检查出异常者有118例,对诊断宫颈上皮内瘤样变（CIN）的特异性为96 5%,敏感性为58.6%,漏诊率为6.4%;阴道镜检查出异常者有163例,对诊断CIN的特异性为97.5%,敏感性为93.4%,漏诊率为1.0%;TCT联合阴道镜检查,其诊断CIN的特异性为96.0%,敏感性为95.4%,漏诊率为0.7%.结论 TCT联合阴道镜检查能提高宫颈癌前病变的检出率,能较早期筛查出宫颈癌前病变,从而有利于早期诊断和早期治疗,提高患者的生存率.

Value of Thinprep cytologic test(TCT)Combined with Colposcopy in the Screening of Cervical Precancerous Lesions

Objective To expl.ore the value of liquid based cytology test （TCT）combined with colposcopy in the screeningof cervical precancerous lesions. Methods Totally 982 patients with cervical precancerous lesion receiving TCT and colposcopy screening in clinic service of our gynecology department in our hospital from July. 2006 to June. 2011 were chosen. Multiple-site bilpsy of cervixes of patients under colposcope was performed for pathological examina tion . The histopathology examination was used us the gold standard . The value of TCT the colposcopy in the diagnosis of cervical lesions was analyzed. Results Among the 982 females . 118 females were abnormal detected by using TCT. The specificity . sensitivity and missed diagnosis rate of TCT for the diagnosis of cervical intraepithelial neoplasia （CIN）were 96.5 %. 58.6 %, and 1.0%. respectively . The 163 females were abnormal detected by using colposcopy . and the specificity . sensitivity and missed diagnosis rate for CIN were 97. 5 %, 93.4 % and 1.0 %, respectively , Furthermore, the specificity ,the sensitivity and missed diagnosis rate of the combination of TCT and colposcopy for CIN were 96.0 %, 95.4 % and 0.7 %, respectively. Conclusion TCT combined with colposcopy can increase the detection rate of cervical precancerous lesion, and earlier screen out cervical precancerous lesions . Thus it is helpful for early di- agnosis and treatment . and can improve the survival rate of patients.