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目的:了解TCT异常患者的组织病理学特点及宫颈高度病变的高危因素的特点。方法:对2003年11月～2008年8月在石景山医院妇科门诊进行TCT检查发现异常的1431例患者行阴道镜检查及镜下多点活检,记录宫颈细胞学、阴道镜、组织病理学结果及高危因素;以组织病理学诊断为“金标准”进行回顾性分析。结果:TCT异常检出率为8.93%;CIN2以上高度病变者占20.4%;宫颈高度病变的高危因素包括:性伴侣超过3个、初次性生活年龄、宫颈糜烂史、分娩数≥2、TCT结果为ASC-H以上病变。结论:TCT异常患者的临床管理以“细胞学-阴道镜检查-组织学病理”三阶梯治疗为佳,加强TCT结果为ASC-H以上患者的管理,加强对有高危因素患者的管理。
Objective: To understand the histopathological features of patients with TCT abnormalities and the characteristics of high risk factors of cervical lesions. Methods: A total of 1431 patients with abnormal TCT examination at gynecology clinic of Shijingshan Hospital from November 2003 to August 2008 were examined by colposcopy and multi-point biopsy under microscope. Cervical cytology, colposcopy and histopathological results were recorded. Risk factors; histopathological diagnosis as “gold standard ” for retrospective analysis. Results: The detection rate of TCT abnormality was 8.93%. The high-grade lesions above CIN2 accounted for 20.4%. The high risk factors of cervical high-grade lesions included more than 3 sexual partners, first-time sexual life, history of cervical erosion, number of childbirth≥2, TCT results ASC-H for the above lesions. Conclusion: The clinical management of patients with abnormal TCT is better than “Cytology - Colposcopy - Histology and Pathology”. The management of patients with ASC-H or more by TCT should be strengthened to strengthen the management of patients with high risk factors.