CAJ | 학술논문

目的评价液基薄层细胞学检测(TCT)在子宫颈病变筛查中的意义.方法采用TCT系统采集子宫颈细胞学标本4234例,按照TBS系统(the Besthesda system)进行判读.对细胞学筛查为异常的272例[意义不明确的非典型性鳞状细胞(ASC-US)或以上病变]进行阴道镜下活组织病理检查.结果 TCT与阴道镜下活组织病理检查结果符合率为低度鳞状上皮内病变(LSIL)85.71%(12/14)、高度鳞状上皮内病变(HSIL)100%(20/20)、鳞状细胞癌(SCC)75.00%(3/4)、腺癌(AC)100%(2/2).TCT诊断不除外高级别鳞状上皮内病变的非典型性鳞状细胞(ASC-H)以上病变的阳性率为23.16%(63/272),活检病理组织学诊断子宫颈上皮内瘤样低度病变(CIN Ⅰ)以上病变的阳性率为24.26%(66/272),二者比较差异无统计学意义(x2=0.868,P=0.581).结论 TCT与活组织病理检查诊断有较高的符合率,二者结合能大大提高对子宫颈的高度病变和子宫颈癌的检出率,减少漏诊.TCT可作为子宫颈癌及癌前病变筛查的一种高效、便捷的方法.
목적 평개액기박층세포학검측(TCT)재자궁경병변사사중적의의.방법 채용TCT계통채집자궁경세포학표본4234례,안조TBS계통(the Besthesda system)진행판독.대세포학사사위이상적272례[의의불명학적비전형성린상세포(ASC-US)혹이상병변]진행음도경하활조직병리검사.결과 TCT여음도경하활조직병리검사결과부합솔위저도린상상피내병변(LSIL)85.71%(12/14)、고도린상상피내병변(HSIL)100%(20/20)、린상세포암(SCC)75.00%(3/4)、선암(AC)100%(2/2).TCT진단불제외고급별린상상피내병변적비전형성린상세포(ASC-H)이상병변적양성솔위23.16%(63/272),활검병리조직학진단자궁경상피내류양저도병변(CIN Ⅰ)이상병변적양성솔위24.26%(66/272),이자비교차이무통계학의의(x2=0.868,P=0.581).결론 TCT여활조직병리검사진단유교고적부합솔,이자결합능대대제고대자궁경적고도병변화자궁경암적검출솔,감소루진.TCT가작위자궁경암급암전병변사사적일충고효、편첩적방법.
Objective To estimate the clinical value of thinprep cytologic test (TCT) in screening cervical lesion. Methods 4234 TCT samples were interpreted according to the Besthesda System (TBS), 272positive cases (ASC-US or above) were taken colposcopic examination and biopsy. Results The coincidence of the results between TCT and biopsy in low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), squamous cell carcinoma (SCC), adenocarcinoma (AC) were 85.71%(12/14), 100 % (20/20), 75 % (3/4) and 100 % (2/2), respectively. The positive rates of over ASC-H by TCT and of over CIN Ⅰ by biopsy were 23.16 % (63/272) and 24.26 % (66/272), respectively. There is no difference between two positive rates (x2 = 0.868, P = 0.581). Conclusion TCT and histopathological diagnosis had a high coincidence, a combination of both can greatly enhance HSIL and cervical cancer and reduce the incidence of missed diagnosis. TCT would be a rapid and convenient method for screening cervical cancer.