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目的探讨液基超薄细胞技术(thinprep cytogic test,TCT)Bethesda系统(TBS)和肿癌相关人乳头状病毒(HPV)检测在宫颈病变诊断的临床应用价值。方法2005年3月至2007年2月在本院就诊的3354病例患者进行TCT检查和TBS细胞学分类诊断,对TCT检查发现异常的患者,进行阴道镜下宫颈活检和HPV检测。结果3354例中检出异常涂片547例(16.31%),其中鳞状细胞癌(SCC)4例,检出率0.12%;高度鳞状上皮内病变(HSIL)75例,检出率2.24%;低度鳞状上皮内病变(LSIL)120例,检出率3.58%;非典型鳞状细胞不排除高度鳞状上皮内病变(ASC-H)28例,检出率0.83%;不能明确意义的非典型鳞状细胞(ASC-US)147例检出率4.38%。非典型腺细胞(AGC)1例,检出率0.03%。肿瘤相关人乳头状病毒的阳性检出率与细胞学分级密切相关,且细胞学和组织学级别基本一致。结论TCT技术结合TBS用于宫颈细胞涂片配合HPV检测和阴道镜下宫颈活检是筛查和诊断子宫颈癌前病变的可靠手段。
Objective To investigate the clinical value of the thinprep cytogic test (TCT) Bethesda system (TBS) and cancer-associated human papillomavirus (HPV) in the diagnosis of cervical lesions. Methods A total of 3354 cases treated in our hospital from March 2005 to February 2007 were diagnosed by TCT and TBS cytology. Cervical biopsy and HPV were examined under colposcopy in patients with abnormal TCT. Results Among the 3354 cases, 547 cases (16.31%) had abnormal smear, of which 4 cases were squamous cell carcinoma (SCC), the detection rate was 0.12%; 75 cases were highly squamous intraepithelial lesion (HSIL), the detection rate was 2.24% ; Low-grade squamous intraepithelial lesion (LSIL) in 120 cases, the detection rate was 3.58%; atypical squamous cell does not rule out the high degree of squamous intraepithelial lesions (ASC-H) in 28 cases, the detection rate of 0.83%; can not be clearly defined Of the 147 cases of atypical squamous cells (ASC-US) had a positive rate of 4.38%. Atypical gland cells (AGC) in 1 case, the detection rate of 0.03%. The positive detection rate of tumor-associated human papillomavirus is closely related to the cytological grade, and the cytology and histological grades are basically the same. Conclusion TCT combined with TBS for cervical smear with HPV test and colposcopic biopsy is a reliable method for screening and diagnosing precancerous lesions of cervical cancer.