液基细胞学诊断子宫颈病变的价值

 目的　评价薄层液基细胞学技术（TCT）检测对子宫颈病变的诊断价值。方法　收集2004年12月至2005年12月妇科门诊就诊患者2134例，采用TCT制片，根据TBS诊断标准，细胞学检查结果异常者行阴道镜子宫颈活检及组织病理学诊断。对发病年龄分布进行分析。结果　TCT阳性检出率为8.37 %（178／2126），其中非典型鳞状上皮细胞（ASC-US）27例（1.27 %），非典型鳞状上皮细胞不除外高度鳞状上皮内病变（ASC-H）14例（0.06 %），鳞状上皮内低度病变（LSIL）34例（1.60 %），鳞状上皮内高度病变（HSIL）11例（0.52 %），鳞状细胞癌（SCC）2例（0.09 %），非典型腺上皮细胞（AGUS）4例（0.19 %），有4例提示人乳头瘤病毒（HPV）感染。TCT与活组织病理诊断阳性符合率LSIL为67.65 %（23／34），HSIL为90.91 %（10／11），SCC为100 %；子宫颈病变的患病率随年龄增加而增长， <55岁年龄组与≥55岁年龄组之间差异有统计学意义（χ2 =10.4252，P＜0.01）。结论　TCT对子宫颈癌的早期诊断有重要的应用价值。

Values of liquid-based cytology in diagnosis of cervical lesions

Objective　To assess the value of liquid-based cytology in diagnosis of cervical lesions. Methods　2134 cases of outpatient of the department of gynecology from Dec. 2004 to Dec. 2005 were detected with Thinprep Cytologic test(TCT) and TBS diagnostic standard. Cervical biopsy under colposcopy and histopathological diagnosis were carried out to those whose cytological results were abnormal. The distribution of age of onset was analyzed. Results　The positive rate of accuracy of TCT was 8.37 %(178/2126). 27 cases(1.27 %) of ASC-US, 14 cases (0.06 %) of ASC-H, 34 cases(1.60 %) of LSIL, 11 cases (0.52 %) of HSIL, 2 cases(0.09 %) of SCC, 4 cases(0.19 %) of AGUS. Among them there were 4 cases cuing HPV infection. The positively corresponding rate of LSIL and HSIL and SCC between TCT and histopathological diagnosis were 67.65 %(23/34), 90.91 %(10/11), 100 %(2/2) respectively; With the increasing of ages, the rate of onset of cervical lesions was increasing. There was statistical significance between age group of ＜ 55 and ≥55, (χ2 = 10.4252, P＜0.01). Conclusion　Liquid-based cytology to early diagnosis of cervical cancers has much important values applied and deserves to extend.