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目的:评价宫颈液基薄层细胞学(TCT)、阴道镜及镜下活检病理结果对宫颈病变的诊断价值。方法:TCT配合阴道镜检查对宫颈病变进行筛查,以组织学诊断为金标准,对结果进行分析。结果:TCT初筛1120例,采用TBS分类,共检出阳性病例98例占8.75%。其中意义不明的非典型鳞状细胞(ASCUS)51例(4.55%),低度上皮内病变(LSIL)23例(2.05%),高度鳞状上皮内病变(HSIL)20例(1.79%),鳞状细胞癌(SCC)4例(0.36%)。对细胞学阳性(ASCUS及以上)或细胞学虽阴性但临床高度可疑病变者共132例进一步行阴道镜检查及镜下活检病理检查,TCT和阴道镜对≥LSIL病变的诊断敏感性分别为55.4%和86.7%(P<0.01);特异性分别为98.0%和90.0%(P>0.05);阳性预测值分别为97.9%和93.5%(P>0.05);阴性预测值分别为56.5%和80.0%(P>0.05)。结论:采用TCT初筛,可提高宫颈病变的阳性检出率,TCT配合阴道镜检查及活检病理可进一步提高宫颈病变的诊断准确率,为临床治疗方法的选择提供可靠依据。
Objective: To evaluate the diagnostic value of cervical cytology (TCT), colposcopy and microscopic biopsy findings on cervical lesions. Methods: Cervical lesions were screened by TCT combined with colposcopy. The histological diagnosis was taken as gold standard and the results were analyzed. Results: A total of 1120 cases of TCT were screened by TBS. A total of 98 positive cases were detected, accounting for 8.75%. Among them, 51 cases (4.55%) of atypical squamous cell carcinoma (ASCUS) of unknown significance, 23 cases (2.05%) of low grade intraepithelial lesion (LSIL) and 20 cases (1.79%) of high grade squamous intraepithelial lesion (HSIL) Squamous cell carcinoma (SCC) in 4 cases (0.36%). For cytology-positive (ASCUS and above) or cytology-negative, but highly clinically suspicious lesions in 132 cases were further colposcopy and microscopy biopsy pathology, TCT and colposcopy in the diagnosis of ≥ LSIL lesions were 55.4 The positive predictive value was 97.9% and 93.5% respectively (P> 0.05), and the negative predictive values were 56.5% and 80.0% respectively (P <0.01) % (P> 0.05). Conclusion: TCT screening can improve the positive detection rate of cervical lesions. TCT combined with colposcopy and biopsy can further improve the diagnostic accuracy of cervical lesions, and provide a reliable basis for the selection of clinical treatment.