液基细胞学结合阴道镜检查对宫颈病变筛查的研究

目的评价Thinprep液基细胞学检查(TCT)配合阴道镜检查对宫颈病变的诊断价值。方法收集2006年5—11月在本院妇科门诊及职工妇科普查的患者行TCT和阴道镜检查,对宫颈病变进行筛查,以宫颈活组织病理诊断为金标准,对结果进行分析。结果对150例最后经组织病理学诊断为异常的患者分别行Thinprep TCT及阴道镜检查,发现TCT采用TBS诊断系统检出意义不明的非典型鳞状上皮细胞(ASCUS)61例,低度鳞状上皮内病变(LSIL)35例,高度鳞状上皮内病变(HSIL)21例,不能排除HSIL的非典型鳞状上皮(ASCH)2例,鳞癌(SCC)1例,其中细胞学检测CIN与病理诊断符合率88.4%。所有患者行阴道镜检查,同时行宫颈活组织病理检查,阴道镜下对宫颈上皮内瘤变(CIN)诊断的符合率为63.1%,与TCT的符合率有显著性差异(P<0.01)。结论TCT可提高宫颈病变的阳性诊断率;细胞学阳性或临床可疑患者应配合阴道镜下活检病理诊断,便于进一步确诊,指导临床早期治疗。

Study of liquid based cytology combined with colposcopy in screening of cervical disease

Objective It is to evaluate the diagnostic value of Thinprep liquid based cytology test(TCT) combined with colposcopy in screening of cervical disease.Methods TCT combined with colposcopy diagnosis of the cases in Quhua Hospital from May,2006 to November,2006 was compared with histopathology diagnosis.Results TCT diagnosis in 150 cases included 61 cases of ASCUS,2 cases of ASCH,35 cases of LSIL,21 cases of HSIL and 1 case of SCC.The conformity rate of TCT and histopathologic diagnosis(88.4%) was greater than that of colposcopy and histopathology diagnosis(63.1%).Conclusion TCT is benefit to improve the conforming to histopathologic.The abnormal results of TCT and the suspicious clinical cases ought to diagnose biopsy of vaginoscopy for the early treatments.