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目的分析妇女疾病的患病状况,对超薄细胞检测(TCT)及TBS(The Bethesda System)分类法在宫颈癌筛查中的应用价值进行综合评价。方法对我院妇科门诊和体检科3000例行TCT的病例,采用TBS分类法作出细胞学诊断报告。结果鳞状上皮异常共188例(6.27%),其中不能明确意义的非典型鳞状细胞(Ascus)95例,低度鳞状上皮内病变(LSIL)66例,倾向于高度病变的非典型鳞状上皮细胞(Ascus-H)15例,高度鳞状上皮内病变(HSIL)12例。提示HPV感染18例,霉菌感染77例,滴虫感染9例,上皮细胞萎缩155例。结论宫颈病变患者年龄趋于年轻化,TCT技术应用于宫颈癌筛查可明显提高宫颈异常细胞检出率。TBS分类法直观、具体,有利于细胞学医生与临床之间的沟通。不能明确意义的Ascus观察3～6个月后复查TCT,Ascus-H、LSIL、HSIL和HP阳性者立即进行阴道镱检查及采取活检证实。
Objective To analyze the prevalence of disease in women and to evaluate the value of TCT and TBS in the screening of cervical cancer. Methods 3000 cases of gynecological clinic and physical examination in our hospital cases of TCT, using TBS classification cytology diagnosis report. Results There were 188 cases (6.27%) of squamous cell abnormalities. Among them, 95 cases of atypical squamous cell (Ascus), 66 cases of low grade squamous intraepithelial lesion (LSIL), 60 cases of atypical squamous cell hyperplasia 15 cases of Ascus-H and 12 cases of high grade squamous intraepithelial lesion (HSIL). Tip HPV infection in 18 cases, 77 cases of mold infection, trichomoniasis infection in 9 cases, 155 cases of epithelial atrophy. Conclusion The age of patients with cervical lesions tend to be young, TCT technology applied to cervical cancer screening can significantly improve the detection rate of cervical abnormal cells. TBS classification is intuitive and specific, which is conducive to communication between cytology doctors and clinicians. Not clear Ascus observed 3 to 6 months after the review TCT, Ascus-H, LSIL, HSIL and HP-positive vaginal ytterbium immediately examination and biopsy confirmed.