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目的探讨液基细胞学联合阴道镜检查在宫颈癌筛查诊断中的临床价值,为提高早期宫颈癌筛查结果的准确性提供参考依据。方法选择2011年1月-2012年12月简阳市妇幼保健院妇科门诊及妇女病普查体检的36 308名妇女作为筛查诊断对象,所有对象均进行液基细胞学(TCT)检查,TCT检查结果为低度鳞状上皮内病变(LSIL)者再进行阴道镜检查,并根据情况行阴道镜下宫颈活检病理检查进行确诊。结果在36 308名接受TCT检查的妇女中有1822例TCT结果为LSIL,检出率为4.4%。其中无明确意义的非典型细胞(ASC-US)872例(2.40%),LSIL 263例(0.72%),高度鳞状上皮内病变(HSIL)89例(0.25%),鳞癌(SCC)42例(0.14%)。TCT检查结果异常者中有1600例接受了阴道镜检查及活检,其中病理检查结果异常(CIN1及以上)者占90.75%。TCT检查结果为LSIL的妇女中,病理结果异常检出率为69.71%,检查结果为HSIL病理结果异常检出率为83.95%,结果为SCC病理结果异常(CIN2及以上者)检出率为42.86%,结果为ASC-US病理结果异常检出率仅占39.0%。结论 TCT联合阴道镜检查在宫颈癌筛查可以提高宫颈癌前病变和癌变的检出率,尽早诊断宫颈癌,为手术创造最佳时机。
Objective To investigate the clinical value of liquid-based cytology combined with colposcopy in the diagnosis of cervical cancer screening and provide reference for improving the accuracy of early cervical cancer screening results. Methods 36 308 women from Gynecology Clinic and Women’s Disease Surveillance in Jianyang Maternal and Child Health Hospital from January 2011 to December 2012 were selected for screening diagnosis. All subjects underwent liquid-based cytology (TCT) and TCT Low-grade squamous intraepithelial lesion (LSIL) were colposcopy and underwent colposcopic cervical biopsy pathology confirmed. Results Of the 36 308 women who underwent TCT, 1822 had TCL results of LSIL with a detection rate of 4.4%. There were 872 cases (2.40%) of ASC-US, 263 cases (0.72%) of LSIL, 89 cases (0.25%) of high grade squamous intraepithelial lesion (HSIL) Example (0.14%). Among the abnormal TCT findings, 1600 received colposcopy and biopsy, of whom 90.75% had pathological abnormalities (CIN1 and above). Among women with TCL test results of LSIL, the abnormality of pathology was detected in 69.71%. The detection rate of HSIL was 83.95%. The detection rate of SCC was 42.86 (CIN2 and above) %, The result is ASC-US pathological results of abnormal detection rate was only 39.0%. Conclusion TCT combined with colposcopy in cervical cancer screening can improve the detection rate of cervical precancerous lesions and cancer, early diagnosis of cervical cancer, to create the best time for surgery.