论文部分内容阅读
目的应用新柏氏程控超薄细胞检测系统(thinprep cytologytest,TCT)检测及Bethesdas(TBS)细胞学分类法在宫颈癌筛查中的应用价值进行综合评价。方法对妇科门诊2100例患者行液基超薄细胞检测,采用TBS分类法,按年龄分为6个组,其中147例上皮异常者进行阴道镜检查和活检作病理诊断对照。结果宫颈上皮内病变为335例,发生率15·95%。包括未明确诊断意义的不典型鳞状细胞(ASCUS)179例(8·53%);未明确诊断意义的不典型腺细胞(AGCUS)2例(0·09%);低度鳞状上皮内病变(LSIL)130例(6·19%);高度鳞状上皮内病变(HSIL)21例(1·00%);鳞状细胞癌(SCC)3例(0·14%)。147例上皮异常者行阴道镜下活检。TCT检测鳞状细胞内病变(SIL及SCC)共68例,组织病理学检查鳞状细胞内病变共67例,两者的诊断符合率为91·16%。结论TCT技术应用于宫颈癌筛查能明显提高宫颈异常细胞检出率。TBS诊断术语的标准化,能使病理细胞学和病理组织学有机地统一;不典型上皮细胞根据个体情况3～6个月随访或进行阴道镜下检查,而人乳头瘤病毒(HPV)高危检查亦可起到分流患者的作用。
Objective To evaluate the clinical value of thinprep cytology test (TCT) and Bethesdas (TBS) cytological classification in cervical cancer screening. Methods A total of 2,100 patients with gynecological outpatients underwent liquid-based ultrathin cell testing. TBS classification was used and divided into 6 groups by age. 147 cases of abnormal epithelium were examined by colposcopy and biopsy for pathological diagnosis. Results Cervical intraepithelial lesions were 335 cases, the incidence of 15.95%. 179 cases (8.53%) of atypical squamous cells (ASCUS) with undetermined diagnosis, 2 cases (0.09%) of atypical glandular cells (AGCUS) without definite diagnosis, low-grade squamous intraepithelial lesion (LSIL) in 130 cases (6.19%), high grade squamous intraepithelial lesion (HSIL) in 21 cases (1.00%) and squamous cell carcinoma (SCC) in 3 cases (0.14%). 147 cases of abnormal epithelium colposcopy biopsy. There were 68 cases of squamous intraepithelial neoplasia (SIL and SCC) detected by TCT, and 67 cases of squamous intraepithelial neoplasia histopathological examination. The diagnostic coincidence rate was 91.16%. Conclusion TCT technique applied to cervical cancer screening can significantly improve the detection rate of cervical abnormal cells. TBS diagnostic terminology standardization, the pathological cytology and histopathology can organically unified; atypical epithelial cells according to individual circumstances 3 to 6 months follow-up or colposcopy, and high-risk human papillomavirus (HPV) test also Can play the role of shunt patients.