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目的通过对宫颈液基薄层细胞学(TCT)检查结果的分析,探讨TCT在妇科门诊宫颈癌筛查中的应用价值。方法对2002年7月至2005年6月3年间14160例门诊患者行TCT检查结果进行回顾性分析。14160例TCT中,宫颈阴道细胞学正常11582例(81.79%),且逐年下降,阴道重度炎症者1071例(7.56%),宫颈鳞状上皮内低度瘤样病变LSIL(CIN1)294例(2.08%),呈上升趋势,分别为1.23%,1.22%,3.48%。宫颈鳞状上皮内高度瘤样病变HSIL(CIN2/3)99例(0.7%),发病率有上升趋势,分别为0.84%,0.55%,0.9%。宫颈鳞癌16例(0.11%),宫颈腺癌3例(0.02%),不典型鳞状细胞(ASCUS)866例(6.12%),3年间发病率逐年升高,分别为1.83%,3.54%,11.57%。人乳头瘤病毒感染(HPV)108例(0.76%),发病率分别为0.99%,0.4%,0.94%;HPV感染在LSIL(CIN1)中占30.59%,在HSIL(CIN2/3)中为11.93%。CIN1,CIN2/3,ASCUS及HPV的高发年龄段均为20～30岁。结论新柏氏TCT系统可提高门诊宫颈癌及癌前病变的检出率。值得担忧的是20～30岁为宫颈癌前病变的高发年龄段,应密切监测。降低HPV感染,治疗并阻止CIN病变升级,是降低宫颈癌发病率的重要环节。HPV感染是CIN的重要相关因素。
Objective To investigate the value of TCT in the screening of cervical cancer in gynecology clinic by analyzing the results of cervical cytology-based thin-layer cytology (TCT). Methods The TCT results of 14 160 outpatients from July 2002 to June 2005 were analyzed retrospectively. Cervical vaginal cytology was normal in 11560 cases (81.79%) in 14 160 cases of TCT, and declined year by year, with 1071 cases (7.56%) of severe vaginal inflammation and 294 cases of cervical squamous intraepithelial lesion-like lesion LSIL (CIN1) %), An upward trend, respectively, 1.23%, 1.22%, 3.48%. Cervical squamous intraepithelial neoplasia HSIL (CIN2 / 3) 99 cases (0.7%), the incidence of an upward trend, respectively, 0.84%, 0.55%, 0.9%. Cervical squamous cell carcinoma in 16 cases (0.11%), cervical adenocarcinoma in 3 cases (0.02%), atypical squamous cells (ASCUS) 866 cases (6.12%), the incidence increased year by year, 1.83%, 3.54% , 11.57%. HPV infection was found in 108 cases (0.76%) with incidences of 0.99%, 0.4% and 0.94%, respectively. HPV infection accounted for 30.59% in LSIL (CIN1) and 11.93 in HSIL (CIN2 / 3) %. The high incidence of CIN1, CIN2 / 3, ASCUS and HPV were 20 to 30 years old. Conclusion New Parker TCT system can improve the detection rate of out-patient cervical cancer and precancerous lesions. It is worth noting that the high incidence of cervical lesions of 20 to 30 years of age, should be closely monitored. Reduce HPV infection, treatment and prevent the progression of CIN lesions is an important part of reducing the incidence of cervical cancer. HPV infection is an important factor in CIN.