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目的:探讨VCE取材Bethesda2001报告系统在宫颈癌筛查中的意义。方法:采用VCE取材Bethesda2001报告系统对3056例健康体检女性进行阴道细胞学检查,并对不明确意义的不典型鳞状上皮细胞(ASC-US)以上病变者经阴道镜取材进行宫颈组织病理学诊断。结果:阴道细胞学检查(VCE取材Bethesda2001报告系统)检出宫颈异常鳞状上皮细胞66例,阳性率2·15%。其中不明确意义的不典型鳞状上皮细胞(ASC-US)17例(25·76%),不除外高度病变的不典型鳞状上皮细胞(ASC-H)4例,(6·06%),低度鳞状上皮内病变(LSIL)28例(42·42%),高度鳞状上皮内病变(HSIL)14例(21·21%),宫颈鳞癌(SCC)3例(4·55%)。66例细胞学阳性诊断病例经宫颈活检组织病理学诊断CINI级以上病变60例(90·91%),其中CINⅠ级35例(53·03%),CINⅡ级12例(18·18%),CINⅢ级7例(10·61%),宫颈鳞癌6例(9·09%)。结论:VCE取材Bethesda2001报告系统取材方便、报告准确,阴道细胞学检查阳性诊断与病理诊断符合率高达90·91%,VCE取材Bethesda2001报告系统在宫颈癌筛查中具有重要意义。
OBJECTIVE: To investigate the significance of VCE-derived Bethesda 2001 reporting system in cervical cancer screening. Methods: The vaginal cytology was performed in 3056 women undergoing VCE test using Bethesda2001 report system. Cervical pathological diagnosis was made by colposcopy in patients with undetermined significance of atypical squamous epithelial cells (ASC-US) . RESULTS: Sixty-six cases of cervical squamous cell carcinoma were detected by vaginal cytology (Bethesda 2001 report system by VCE). The positive rate was 2.15%. Among them, 17 cases (25.76%) had atypical squamous cell (ASC-US) with undefined significance, 4 cases (ASC-H) had atypical squamous cell carcinoma (ASC-H) 28 cases (42.42%) had low grade squamous intraepithelial lesion (LSIL), 14 (21.21%) had high grade squamous intraepithelial lesion (HSIL), 3 had squamous cell carcinoma of the cervix %). Sixty-six cases (90.91%) of the CINI-grade lesions were diagnosed by biopsy in 66 cases of cytology-positive cases, of which 35 cases (53.03%) were CINⅠ, 12 cases (18.18%) were CINⅡ, CIN Ⅲ grade in 7 cases (10.61%), cervical squamous cell carcinoma in 6 cases (9.09%). CONCLUSION: The VCE-derived Bethesda2001 report system is easy to draw and report accurately. The coincidence rate of positive vaginal examination and pathological diagnosis is 90.91%. The VCE-derived Bethesda2001 report system is of great significance in cervical cancer screening.