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目的评价Thinprep液基细胞学检测技术(简称TCT)及TBS系统在宫颈病变诊断中的应用价值。方法对11000例受检者的宫颈细胞采用TCT技术检测和TBS分类诊断,将诊断意义不明的不典型鳞状细胞(ASCUS)以上病变均列为细胞阳性病例,并进行阴道镜下多点取材活检,以病理学结果为金标准,将细胞学结果与活检结果作对照分析。结果TCT法标本满意率为96.36%,细胞阳性病例1206例,总检出率10.96%(1206/11000):其中癌(CA)15例(占0.14%,);高度鳞状上皮内病变(HSIL)89例(占0.81%);低度鳞状上皮内病变(LSIL)449例(4.08%);不除外高度鳞状上皮内病变的不典型鳞状细胞(ASC-H)73例(占0.66%);ASC-US+AGUS共580例(占5.27%)。对其中1128例进行病理检查:宫颈癌和癌前病变的病理阳性率和准确率分别是CA(100%,100%);HSIL(100%,91.01%);LSIL(67.12%,57.82%);ASC-H(54.17%,27.78%);ASC-US+AGUS病理阳性率是14.09%。结论TCT技术和TBS系统能准确、全面地反映宫颈癌和癌前病变,以及细菌、病毒、其它病原体的感染情况,是目前一种高效的宫颈癌筛查的一种手段。
Objective To evaluate the value of Thinprep liquid-based cytology (TCT) and TBS system in the diagnosis of cervical lesions. Methods Cervical cells from 11000 subjects were diagnosed by TCT and TBS classification. The above lesions with atypical diagnosis of atypical squamous cell carcinoma (ASCUS) were all classified as cell positive cases and colposcopy multipoint biopsy , The pathological results for the gold standard, the cytology results and biopsy results for controlled analysis. Results The total positive rate of TCT was 96.36% and the number of positive cases was 1206 (10.96%, 1206/11000), including 15 (0.14%) cases of cancer (CA), 15 cases of high grade squamous intraepithelial lesion ), 89 cases (0.81%), 449 cases (4.08%) of low grade squamous intraepithelial lesion (LSIL), and 73 cases of atypical squamous cell (ASC-H) %); ASC-US + AGUS 580 cases (5.27%). Pathological examination was performed on 1128 of them: pathological positive rate and accuracy of cervical cancer and precancerous lesions were CA (100%, 100%), HSIL (100%, 91.01%), LSIL (67.12%, 57.82% ASC-H (54.17%, 27.78%). The positive rate of ASC-US + AGUS was 14.09%. Conclusion TCT technique and TBS system can accurately and comprehensively reflect the cervical cancer and precancerous lesions as well as the infection of bacteria, viruses and other pathogens. It is an efficient screening method for cervical cancer.