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目的:研究宫颈TCT结果与阴道镜下活组织检查病理结果之间的关系,并探讨宫颈病变三阶梯法诊治的临床意义。方法:回顾性总结了2006年1月~2008年4月孝感市中心医院采用ThinPrep膜式液基超薄细胞学检查系统(TCT)收集宫颈细胞总计进行了9 912次的检测,报告结果采用TBS分类系统(2001年)。其中细胞学筛查结果异常的病例,由临床医师建议患者愿意者行阴道镜检查及宫颈多点活检送病理检查,将结果为CINⅠ、CINⅡ、CINⅢ/CIS按年龄分组,描述细胞学检查结果与病理检查结果之间的关系,并行统计学相关性分析。结果:9 912例受检者中,阳性涂片775例,753例行阴道镜下活检。其中意义不明的不典型鳞状上皮细胞(ASCUS)432例(4.14%),鳞状上皮内低度病变(LSIL)186例(2.12%),鳞状上皮内高度病变(HSIL)46例(0.46%),鳞状细胞癌(SCC)7例,HPV感染24例。细胞学与阴道镜活检结果符合率LSIL为75.61%,HSIL为31.94%,SCC为21.21%。结论:阴道镜检查及活检可以较好地检出TCT结果异常病例中的CINⅠ级以上病变。TCT提示异常的病例,其组织学病理为CINⅡ、CINⅢ/CIS的机率远大于正常人群。
Objective: To study the relationship between cervical TCT results and pathological results of biopsy under colposcopy and investigate the clinical significance of three-step diagnosis and treatment of cervical lesions. Methods: From January 2006 to April 2008, Xiaogan Central Hospital collected 9 912 cervical smears collected by ThinPrep membrane-based ultrathin cytology (TCT), and the results were analyzed by TBS Classification System (2001). Among them, abnormal results of cytology screening were recommended by clinicians for colposcopy and cervical multipoint biopsy. The results were classified as CINⅠ, CINⅡ, CINⅢ / CIS by age, and the results of cytology were described The relationship between the pathological findings, parallel statistical analysis. Results: Of the 9 912 subjects, 775 were positive smears and 753 were colposcopic biopsies. There were 432 cases (4.14%) of ASCUS, 186 cases (2.12%) of LSIL, 46 cases (46 cases) of squamous intraepithelial lesion (HSIL) %), Squamous cell carcinoma (SCC) in 7 cases, HPV infection in 24 cases. The coincidence rates between cytology and colposcopy biopsy were 75.61% for LSIL, 31.94% for HSIL and 21.21% for SCC. Conclusion: Colposcopy and biopsy can detect more than CIN Ⅰ-level lesions in abnormal TCT results. TCT prompted abnormal cases, the histological pathology of CIN Ⅱ, CIN Ⅲ / CIS probability is much larger than the normal population.