中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2015年
7期
126-126,128
,共2页
闵志雪%刘萌萌%屈彩霞%魏丽%刘鹏%高洁
閔誌雪%劉萌萌%屈綵霞%魏麗%劉鵬%高潔
민지설%류맹맹%굴채하%위려%류붕%고길
宫颈液基薄层细胞学%宫颈疾病%诊断
宮頸液基薄層細胞學%宮頸疾病%診斷
궁경액기박층세포학%궁경질병%진단
Liquid based cervical cytology%Cervical disease%Diagnosis
目的：探讨影响妇科液基薄层细胞学诊断一致性的因素。方法：2013年1月-2014年6月收集细胞学异常病例213例，将细胞学结果与组织学结果对照分析，复查液基细胞学及组织学切片，分析相符程度及误诊原因。结果：共3010例受检者进行液基薄层细胞学检查，其中细胞学诊断为 ASC-US 143例(4.75%)，ASC-H 41例(1.36%)，LSIL 54例(1.79%)，HSIL 25例(0.83%)，SCC 7例(0.23%)。270例细胞学异常的病例其组织学诊断为LSIL、HSIL、SCC分别为92例、60例、20例，与细胞学符合率分别为77.8%、72%、71.4%。误诊的原因主要为取材部位不适当、放化疗反应、萎缩及反应性上皮、对低分化细胞学病变认识不足、某些细胞学片中缺乏典型病变特征。结论：妇科液基薄层细胞学对宫颈病变阳性预测值较高，但存在与组织学诊断结果不符合的情况，细胞学医师应提高诊断水平，临床妇科医师应充分认识避免造成不一致的因素。
目的：探討影響婦科液基薄層細胞學診斷一緻性的因素。方法：2013年1月-2014年6月收集細胞學異常病例213例，將細胞學結果與組織學結果對照分析，複查液基細胞學及組織學切片，分析相符程度及誤診原因。結果：共3010例受檢者進行液基薄層細胞學檢查，其中細胞學診斷為 ASC-US 143例(4.75%)，ASC-H 41例(1.36%)，LSIL 54例(1.79%)，HSIL 25例(0.83%)，SCC 7例(0.23%)。270例細胞學異常的病例其組織學診斷為LSIL、HSIL、SCC分彆為92例、60例、20例，與細胞學符閤率分彆為77.8%、72%、71.4%。誤診的原因主要為取材部位不適噹、放化療反應、萎縮及反應性上皮、對低分化細胞學病變認識不足、某些細胞學片中缺乏典型病變特徵。結論：婦科液基薄層細胞學對宮頸病變暘性預測值較高，但存在與組織學診斷結果不符閤的情況，細胞學醫師應提高診斷水平，臨床婦科醫師應充分認識避免造成不一緻的因素。
목적：탐토영향부과액기박층세포학진단일치성적인소。방법：2013년1월-2014년6월수집세포학이상병례213례，장세포학결과여조직학결과대조분석，복사액기세포학급조직학절편，분석상부정도급오진원인。결과：공3010례수검자진행액기박층세포학검사，기중세포학진단위 ASC-US 143례(4.75%)，ASC-H 41례(1.36%)，LSIL 54례(1.79%)，HSIL 25례(0.83%)，SCC 7례(0.23%)。270례세포학이상적병례기조직학진단위LSIL、HSIL、SCC분별위92례、60례、20례，여세포학부합솔분별위77.8%、72%、71.4%。오진적원인주요위취재부위불괄당、방화료반응、위축급반응성상피、대저분화세포학병변인식불족、모사세포학편중결핍전형병변특정。결론：부과액기박층세포학대궁경병변양성예측치교고，단존재여조직학진단결과불부합적정황，세포학의사응제고진단수평，림상부과의사응충분인식피면조성불일치적인소。
Objective:To investigate the effect of gynecological liquid based cytology diagnosis consistency.Methods: 213 cases of cytological abnormalities were collected from January 2013 to June 2014.We analysed the cytology results and histological results, and reviewed the liquid based cytology and histological sections.We analyzed the consistent degree and the causes of misdiagnosis.Results:A total of 3 010 cases were investigated thinprep cytology.The cytological diagnosis of ASC-US in 143 cases(4.75% ),ASC-H in 41 cases(1.36% ),LSIL in 54 cases(1.79% ),25 cases were HSIL(0.83% ),SCC in 7 cases(0.23% ).The histological diagnosis of 270 cases of abnormal cytology were LSIL,HSIL,SCC were 92,60,20 cases respectively,and the coincidence rate with cytological was 77.8%,72%,71.4% respectively.The causes of misdiagnosis mainly as the materials and inappropriate,response to chemoradiotherapy,atrophy and reactive epithelium,low differentiated cytological lesions understanding insufficiency,some cytology film lack dian lesion characteristics.Conclusion:The value of gynecology of liquid based cytology in cervical lesions positive predictive is high, but there exist not meet to the histological diagnosis results situation.The cytological physicians should improve the level of diagnosis,and the clinical gynecologists should fully understand the factors that cause the inconsistency avoidance.
