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目的探讨液基超薄细胞技术(thinp rep cytologic test,TCT)和Bethesda系统(TBS)在早期宫颈病变诊断中的临床价值。方法对2005年5月至2007年7月在新疆医科大学第一临床医学院就诊的9003例患者进行TCT检查和TBS细胞学分类诊断,对TCT检查发现异常的患者进行阴道镜病理检查。结果9003例涂片中检出异常涂片452例(5·02%),其中不典型鳞状细胞(ASC)187例(2·08%),低度鳞状上皮内病变(LSIL)203例(2·25%),高度鳞状上皮内病变(HSIL)41例(0·46%),鳞状细胞癌(SCC)3例(0·03%)。30~39岁年龄段,异常涂片最高178例(39·38%),其次是40~49岁年龄段126例(27·88%),与其他年龄组相比差异有统计学意义(P<0·05)。TCT与病理检查符合率分别为LSIL71·00%、HSIL94·00%、SCC100%,两者比较差异无统计学意义。结论TCT技术结合TBS应用于宫颈细胞涂片配合阴道镜活检,是筛查和诊断子宫颈癌前病变的可靠手段。
Objective To investigate the clinical value of thinp rep cytologic test (TCT) and Bethesda system (TBS) in the diagnosis of early cervical lesions. Methods 9003 patients treated in the First Clinical College of Xinjiang Medical University from May 2005 to July 2007 were diagnosed by TCT and TBS cytology. Colposcopy pathology was performed on patients with abnormal TCT findings. Results Of the 9003 smears, 452 (5.02%) were detected abnormal smears, including 187 cases (208.08%) of atypical squamous cells (ASC), 203 cases of low grade squamous intraepithelial lesion (LSIL) (2.25%), 41 cases (0.46%) of high grade squamous intraepithelial lesion (HSIL) and 3 cases (0.3%) of squamous cell carcinoma (SCC). In the age group of 30-39 years, abnormal smear was the highest in 178 cases (39.38%), followed by 126 cases (27.88%) in the age group of 40-49 years, with significant difference compared with other age groups (P <0 · 05). The coincidence rates of TCT and pathology were LSIL71 · 00%, HSIL94 · 00% and SCC100% respectively, with no significant difference between the two. Conclusion TCT combined with TBS in cervical smears combined with colposcopy biopsy is a reliable method to screen and diagnose cervical precancerous lesions.