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目的通过对湖北地区体检妇女进行宫颈细胞学筛查,探讨薄层液基细胞学检查(TCT)在宫颈癌筛查中的应用价值,并分析该地区宫颈癌及癌前病变的发生率,为防治宫颈癌提供理论依据。方法选取2015年8月-2016年3月在该院体检中心进行体检的14 686例妇女为研究对象,对其进行宫颈细胞学筛查,将TCT筛查结果为无明确诊断意义的非典型鳞状上皮细胞(ASC-US)及以上病例进行阴道镜检查和宫颈活检。结果 TCT检查阳性患者154例,上皮细胞异常比率为1.05%,其中ASC-US 78例,无明确诊断意义的非典型鳞状上皮细胞不除外高度病变(ASC-H)3例,低度鳞状上皮内病变(LSIL)56例,高度鳞状上皮内病变(HSIL)12例,宫颈鳞状细胞癌(SCC)0例,非典型腺细胞(AGC)5例,宫颈腺癌(AC)0例,ASC/SIL比率为1.19。活检结果宫颈炎病例共76例(49.4%),CINⅠ57例(37.0%),CINⅡ13例(8.4%),CINⅢ5例(3.2%),SCC 2例(1.3%),AC 1例(0.6%)。CINⅠ及以上病例中细胞学诊断特异性高达97.1%。结论宫颈细胞学检查是宫颈癌筛查的有效且性价比最高的筛查手段,从制片技术、取材水平和阅片技术等方面提高细胞学灵敏度是众多细胞学工作者继续努力的方向,必要时应联合应用人乳头瘤病毒(HPV)检测。
Objective To investigate the value of TCT screening in screening cervical cancer by screening cervical cytology in Hubei women and analyze the incidence of cervical cancer and precancerous lesions in this area as Provide a theoretical basis for prevention and treatment of cervical cancer. Methods A total of 14 686 women who performed physical examinations at the medical examination center of the hospital from August 2015 to March 2016 were selected for cervical cytology screening. The results of TCT screening were atypical scales with no definite diagnosis Like epithelial cells (ASC-US) and above colposcopy and cervical biopsy. Results There were 154 cases with positive TCT and 1.05% epithelial abnormality. Among them, ASC-US 78 cases, nonspecific squamous cell with no definite diagnosis (ASC-H), 3 cases with low-grade squamous 56 cases of LSIL, 12 cases of high grade squamous intraepithelial lesion (HSIL), 0 cases of cervical squamous cell carcinoma (SCC), 5 cases of atypical glandular cells (AGC), 0 cases of cervical adenocarcinoma (AC) The ASC / SIL ratio is 1.19. The biopsy results included 76 cases (49.4%) of cervicitis cases, CINⅠ57 cases (37.0%), CINⅡ13 cases (8.4%), CINⅢ cases (3.2%), SCC 2 cases (1.3%) and ACC cases (0.6%). CIN Ⅰ and above cases cytology specificity as high as 97.1%. Conclusion Cervical cytology is an effective and cost-effective screening method for cervical cancer screening. It is the direction of many cytological workers to improve the sensitivity of cytology from the aspects of filmmaking technique, drawing quality and reading technique. If necessary, Should be combined with human papillomavirus (HPV) test.