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目的 通过与病理组织学比较 ,评价宫颈脱落细胞计算机辅助细胞检测 (CCT)在宫颈病变诊断中的准确性及应用价值。方法 首都医科大学附属北京友谊医院对 1997年 12月至 2 0 0 2年 7月行宫颈脱落细胞CCT检查的 1372例患者在电子阴道镜下取宫颈活组织进行病理组织学检查。结果 CCT结果正常为 8 75 %(12 0 / 1372 ) ,不典型鳞状细胞 (ASCUS) 6 0 0 6 % (82 4 / 1372 ) ,低度鳞状上皮内病变 (LSIL) 2 5 2 9% (347/ 1372 ) ,高度鳞状上皮内病变 (HSIL) 5 5 4 % (76 / 1372 ) ,鳞癌及腺癌分别为 0 2 9% (4 / 1372 )和 0 0 7% (1/ 1372 )。经阴道镜下多点活检后的病理组织学检查 ,诊断为炎症者 5 2 4 1% (719/ 1372 ) ,宫颈上皮内瘤变 (CIN)Ⅱ和CINⅢ增加到16 84 % (2 31/ 1372 )。ASCUS患者 10 4 4 %病理组织学结果为CINⅡ ,2 0 6 %为CINⅢ ,0 4 9%为鳞癌。CCT与病理组织学的符合率在LSIL中为 2 8 82 % ,在HSIL中为 5 2 6 3% ,在鳞癌为 75 0 0 %。CCT与病理组织学在人乳头瘤病毒 (HPV)诊断上有较大差异 (P <0 0 1)。结论 CCT与病理组织学有一定的相关性 ,可作为判断宫颈病变程度的参考指标 ,同时CCT有一定的假阴性及假阳性率。
Objective To evaluate the accuracy and application value of computer assisted cell detection (CCT) of cervical exfoliated cells in the diagnosis of cervical lesions by comparing with histopathology. Methods Beijing Friendship Hospital Affiliated to Capital Medical University from December 1997 to July 2002 cervical cytological examination of 1372 cases of patients with cervical cytology under the pathological examination of cervical biopsy. Results The results of CCT were 8 75% (12 0/1372), ASCUS 6 0 06% (82 4/1372), low grade squamous intraepithelial lesion (LSIL) 25 59% (347/1372), high-grade squamous intraepithelial lesion (HSIL) 55.4% (76/1372), squamous cell carcinoma and adenocarcinoma respectively 0 2 9% (4/1372) and 0 0 7% (1/1372 ). After colposcopy biopsy, pathological examination showed that 5 2 4 1% (719/1372), CIN Ⅱ and CIN Ⅲ were increased to 16 84% (2 31/1372) ). The ASCUS patients had 104.4% histopathologic findings as CINⅡ, 206% as CINⅢ, and 0 49% as squamous cell carcinomas. The coincidence rate between CCT and histopathology was 2 8 82% in LSIL, 5263% in HSIL and 75 0% in squamous cell carcinoma. CCT and histopathology in the diagnosis of human papillomavirus (HPV) have a greater difference (P <0 01). Conclusion CCT has some correlation with histopathology, which can be used as a reference index to judge the degree of cervical lesions. CCT has some false negatives and false positive rates.