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目的:探讨液基薄层细胞学检测(liquid-based thinPrep cytology test,TCT)联合宫颈活检对诊断宫颈鳞状上皮病变的临床价值。方法:应用TCT对30350例受检者进行宫颈细胞学检查,细胞学检查结果为鳞状上皮异常者,进行阴道镜活检及病理检查。结果:TCT检出鳞状上皮异常者1824例(6.01%),其中无明确意义的不典型鳞状细胞(atypical squamous cells of undetermined significance,ASC-US)1423例,不除外高度鳞状上皮病变的不典型鳞状细胞(atypical squamous cells cannot exclude high gradeintraep ithelial lesion,ASC-H)214例,低度鳞状上皮内病变(low grade squamous intraepithelial lesion,LSIL)92例,高度鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)80例,鳞状细胞癌(squamouscellcarcinoma,SCC)15例。与活检病理检测结果相比,1423例ASC-US中,宫颈上皮内瘤样病变-I级(grade I cervical intraepithelial neoplasia,CIN-I)202例、CIN-Ⅱ和CIN-Ⅲ22例、SCC1例;214例ASC-H中,CIN-I12例、CIN-Ⅱ和CIN-Ⅲ101例、SCC5例;LSIL、HSIL及SCC组中与组织病理检测结果的符合率分别为63.04%(58/92)、81.25%(65/80)及100%(15/15),SCC组和HSIL组的组织学符合率高于LSIL组(P<0.01)。结论:TCT与阴道镜活检病理检测结果有较高的符合率,二者联合能提高宫颈癌前病变及癌变的检出率。
Objective: To investigate the clinical value of liquid-based thinPrep cytology test (TCT) combined with cervical biopsy in the diagnosis of cervical squamous cell lesion. Methods: Twenty three thousand three hundred and fifty subjects underwent cervical cytology with TCT. The results of cytology were squamous epithelial abnormalities, colposcopy biopsy and pathological examination. Results: There were 1824 cases (6.01%) of squamous cell abnormalities detected by TCT, including 1423 cases of atypical squamous cells of undetermined significance (ASC-US), no abnormality of squamous epithelial lesions 214 cases of atypical squamous cells can not exclude high grade intraepithelial lesion (ASC-H), 92 cases of low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion grade squamous intraepithelial lesion (HSIL) 80 cases, squamous cell carcinoma (SCC) in 15 cases. Compared with biopsy results, 202 cases of grade I cervical intraepithelial neoplasia (CIN-I), 22 cases of CIN-II and CIN-Ⅲ and 1 case of SCC were found in 1423 cases of ASC-US. In 214 cases of ASC-H, there were CIN-I in 12 cases, CIN-II and CIN-III in 101 cases and SCC in 5 cases. The coincidence rates of LSINH, CIN-II and SCC were 63.04% (58/92) % (65/80) and 100% (15/15) respectively. The coincidence rate of histology in SCC group and HSIL group was higher than that in LSIL group (P <0.01). Conclusion: TCT and colposcopy biopsy pathology test results have a high coincidence rate, the combination of the two can improve the cervical precancerous lesions and cancer detection rate.