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目的研究并探讨三阶梯技术对宫颈癌早期筛查的应用价值。方法 400例接受宫颈癌筛查的细胞学检查异常育龄期妇女作为研究对象,所有受检者均接受三阶梯技术宫颈癌筛查,依次实施液基薄层细胞学检查(TCT)、阴道镜检查、宫颈活检病理检查,对三阶梯技术宫颈癌筛查结果进行分析。结果相比于宫颈活检病理检查,TCT对意义不明确且不典型的鳞状细胞(ASCUS)、高度鳞状上皮内病变的不典型鳞状细胞(ASCH)、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)、鳞状细胞癌(SCC)、非典型的腺癌(AGC)的诊断符合率分别为62.39%、68.22%、93.51%、95.31%、100.00%、100.00%,LSIL及以上病变的诊断符合率高于ASCUS、ASCH,而阴道镜检查对宫颈炎、宫颈上皮内瘤变(CIN)Ⅰ级、CINⅡ级、CINⅢ级以及宫颈癌的诊断符合率分别为74.44%、81.82%、87.21%、91.25%、96.43%,差异无统计学意义(P>0.05)。结论在宫颈癌早期筛查中,采用三阶梯技术筛查可有效减少漏诊、误诊,提高宫颈癌的早期检出率,为宫颈癌的临床防治提供借鉴和帮助。
Objective To study and discuss the value of three-step technique in early screening of cervical cancer. Methods A total of 400 women of childbearing age who had undergone cytological examination for cervical cancer screening were enrolled in this study. All subjects underwent three-step cervical cancer screening, followed by liquid-based thin-layer cytology (TCT) and colposcopy , Cervical biopsy pathology, cervical cancer screening results of the three-step technology analysis. Results Compared with cervical biopsy pathology, TCT showed no significant difference in atypical squamous cell (ASCUS), atypical squamous cell (ASCH) in highly squamous intraepithelial lesion, low grade squamous intraepithelial lesion (LSIL) ), High-grade squamous intraepithelial lesion (HSIL), squamous cell carcinoma (SCC) and atypical adenocarcinoma (AGC) were 62.39%, 68.22%, 93.51%, 95.31%, 100.00%, 100.00 % .The diagnostic coincidence rate of LSIL and above lesions was higher than that of ASCUS and ASCH. The diagnostic coincidence rates of colposcopy for cervicitis, cervical intraepithelial neoplasia (CIN) Ⅰ, CIN Ⅱ, CIN Ⅲ and cervical cancer were 74.44 %, 81.82%, 87.21%, 91.25% and 96.43%, respectively, with no significant difference (P> 0.05). Conclusion In the early screening of cervical cancer, the use of three-step screening can effectively reduce the missed diagnosis, misdiagnosis and improve the early detection rate of cervical cancer, provide reference and help for the clinical prevention and treatment of cervical cancer.