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目的:比较巴氏五级分类法与TBS报告系统诊断宫颈细胞异常的阳性率及其与组织病理学诊断的符合率,探讨TBS报告系统在传统宫颈涂片细胞学诊断中的应用价值。方法:对接受宫颈癌及癌前病变筛查者,其中2005年1月至2008年12月间的3781例进行传统宫颈涂片、巴氏染色、巴氏五级分类法进行细胞学诊断;2009年1月至2010年12月间的7888例进行宫颈涂片、巴氏染色、TBS报告系统进行细胞学诊断,其阳性结果的患者进行阴道镜下取宫颈活检、组织病理学检查。结果:使用TBS报告系统诊断检出宫颈异常细胞的阳性率为0.87%(69/7888),与组织病理学诊断总的符合率为95.7%(44/46),均明显高于巴氏五级分类法(P<0.01);传统宫颈涂片经济、简便易行、重复性好、适合于大规模的普查。结论:TBS报告系统可很好的使用于传统涂片的宫颈脱落细胞学检查,尤其在经济欠发达地区宫颈癌筛查中值得推广应用。
OBJECTIVE: To compare the diagnostic accuracy of Pap test and TBS reporting system for diagnosis of cervical cell abnormality and its coincidence rate with histopathological diagnosis, and discuss the value of TBS reporting system in traditional cervical smear cytology. Methods: A total of 3781 cases of cervical cancer and precancerous lesions were screened from January 2005 to December 2008 for cytological diagnosis by traditional Pap smear, Papanicolaou smear and Papanicolaou grade 5 classification. From January to December 2010, 7888 women underwent cervical smear, Papanicolaou and TBS reporting system for cytological diagnosis. The patients with positive results underwent colposcopic biopsy and histopathological examinations. Results: The positive rate of cervical abnormal cells detected by TBS was 0.87% (69/7888) and the overall coincidence rate was 95.7% (44/46) with histopathological diagnosis, which were significantly higher than those of Pap. Classification (P <0.01); traditional cervical smear economy, simple, reproducible, suitable for large-scale census. Conclusion: The TBS reporting system can be used well in cervical smear cytology of traditional smears, especially in cervical cancer screening in economically underdeveloped areas.