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目的:探讨液基细胞学(LCT)在妇科病人人群中宫颈病变的准确性,评价LCT在子宫颈癌早期诊断中的价值。方法: 对15274例LCT中有活组织检查对照的794例进行回顾性分析。结果:LCT LSIL以上病变的阳性率35．7％(284/794), 活检CIN Ⅰ以上病变阳性率41．8％(332／794),两者统计学比较无明显差异(P>0．05),LCT的假阴性(漏诊)率分别为 LSIL31．9％(53/158)、HSIL17．5％(21/120)、SCC15．4％(6/39)、AC50％(1／2)。假阳性(误诊)率分别为LSIL22．9％(41/179)、 HSIL5．2％(5／96)、SCC0．0％(0/6)、AC0．0％(0／1)。结论:液基细胞学检查是宫颈癌及癌前病变筛查的有效手段,但也有其局限性,获取满意的宫颈细胞标本对提高诊断准确性有重要意义,阴道镜检查及宫颈多点活检可弥补液基细胞学检查假阴性的疏漏。而对LSIL及以上病变由两位病理医生按诊断标准共同诊断是避免假阳性的主要措施。
Objective: To investigate the accuracy of liquid-based cytology (LCT) in cervical lesions in gynecologic patients and to evaluate the value of LCT in the early diagnosis of cervical cancer. Methods: A retrospective analysis was performed on 794 cases of biopsies in 15,274 patients with LCT. Results: The positive rate of lesions above LCT LSIL was 35.7% (284/794) and the positive rate of lesions above CIN Ⅰ was 41.8% (332/794). There was no significant difference between the two groups (P> 0.05 ), False negative (missed diagnosis) rate of LCT were LSIL31.9% (53/158), HSIL17.5% (21/120), SCC15.4% (6/39) and AC50% (1/2) respectively. The false-positive rates were 22.9% (41/179) for LSIL, 5.2% (5/96) for HSIL, 0% (0/6) for SCC and 0% (0/1) for ACO. Conclusion: Liquid-based cytological examination is an effective method for screening cervical cancer and precancerous lesions, but it also has its limitations. Acquiring satisfactory cervical cell samples is of great importance to improve the diagnostic accuracy. Colposcopy and multiple biopsy of the cervix Make up for missing smears of liquid-based cytology false negatives. The LSIL and above lesions by the two pathologists diagnosed by the diagnostic criteria for co-diagnosis is to avoid false positive main measures.