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目的 探讨液基细胞学检查(the ThinPrep cytology test,TCT)在宫颈早期病变诊断中的应用价值。方法 对四川省妇幼保健院2009年7月至2011年5月门诊机会性筛查5164例妇女TCT结果与组织病理学检查结果进行对比分析。结果 5164例TCT筛查中,细胞学阳性306例(5.93%),其中意义不明的非典型鳞状上皮(atypical squamous cell of undetermined signification,ASCUS)163例(3.16%),非典型鳞状上皮—不除外高度鳞状上皮内病变(atypical squamous cell,cannot exclude high-grade squamous intraepithelial lesion,ASC-H)29例(0.56%),低度鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)101例(1.96%),高度鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)11例(0.21%),鳞状细胞癌(squamous cell carcinoma,SCC)1例(0.02%),非典型腺细胞,倾向肿瘤(atypical glandular cell,favor neoplasia,AGC,FN)1例(0.02%)。TCT阳性结果与阴道镜下病理活检结果符合率:ASCUS为48.28%(42/87),ASC-H为82.61%(19/23),LSIL为56.00%(42/75),HSIL为81.82%(9/11),SCC为100.00%(1/1),AGC,FN为0%(0/0)。结论 TCT是筛查宫颈癌及癌前病变的重要手段和首选方法,且与组织病理学检查具有较高的符合率,有利于预防宫颈癌的发生。
Objective To investigate the value of TCT in the diagnosis of early cervical lesions. Methods A comparative analysis was made between the results of TCT and the results of histopathological examination in 5164 women from Sichuan Women’s and MCH Hospital from July 2009 to May 2011. Results Among the 5164 cases of TCT screening, 306 (5.93%) were cytologically positive, of which 163 cases (3.16%) had atypical squamous cell of undetermined signification (ASCUS), atypical squamous cell - 29 cases (0.56%) of low-grade squamous intraepithelial lesion (ASC-H), low-grade squamous intraepithelial lesion (LSIL) Eleven cases (1.96%), 11 cases (0.21%) of high-grade squamous intraepithelial lesion (HSIL) and 1 case (SCC) of squamous cell carcinoma (SCC) One case (0.02%) of atypical glandular cell, favor neoplasia (AGC, FN). The coincidence rates of TCT positive results and colposcopic biopsy results were 48.28% (42/87) for ASCUS, 82.61% (19/23) for ASC-H, 56.00% (42/75) for LSIL and 81.82% for HSIL 9/11), SCC 100.00% (1/1), AGC, FN 0% (0/0). Conclusion TCT is an important method and the preferred method for screening cervical cancer and precancerous lesions, and has a high coincidence rate with histopathological examination, which is propitious to prevent the occurrence of cervical cancer.