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目的:评价液基细胞学(thinprep cytologic test,TCT)在宫颈病变筛查中的准确性。方法:回顾性分析武汉市中心医院2008年7月～2010年5月宫颈TCT筛查与宫颈活检结果603例。结果:30～49岁年龄段患者381例(63.18%),细胞学结果在正常、LSIL、HSIL中与组织学结果符合率分别为90.76%、11.54%、60.00%,TCT诊断准确性为88.89%,敏感性为66.00%,特异性为95.43%。不典型上皮内瘤变(atypical squamous cells,ASC)378例对应组织学结果分别为正常285例,宫颈上皮内瘤变(cervical intraepithelialneoplasia,CIN)Ⅰ25例,CINⅡ～Ⅲ65例,宫颈鳞状上皮细胞癌(squamous cellcarcinoma,SCC)3例。P16与Ki-67阳性率在组织学结果为正常或炎症,CINⅠ与CINⅡ～Ⅲ分别为50.00%,60.00%,100.00%和67.00%,80.00%,100.00%。结论:TCT是一种准确性高的筛查方法,对临床医生分析宫颈病变有指导意义。
Objective: To evaluate the accuracy of thinprep cytologic test (TCT) in cervical lesions screening. Methods: A retrospective analysis of Wuhan Central Hospital from July 2008 to May 2010 cervical TCT screening and cervical biopsy results of 603 cases. Results: There were 381 cases (63.18%) in the age group of 30-49 years. The coincidence rates of cytology and histology were 90.76%, 11.54% and 60.00% respectively in LSIL and HSIL. The diagnostic accuracy of TCT was 88.89% , The sensitivity was 66.00% and the specificity was 95.43%. The corresponding histological findings of 378 cases of atypical squamous cells (ASC) were 285 cases of normal, 25 cases of cervical intraepithelial neoplasia (CIN) Ⅰ, 65 cases of CIN Ⅱ ~ Ⅲ, cervical squamous cell carcinoma (squamous cellcarcinoma, SCC) in 3 cases. The positive rates of P16 and Ki-67 were normal or inflammatory in histological examination. The rates of CINⅠ and CINⅡ ~ Ⅲ were 50.00%, 60.00%, 100.00% and 67.00%, 80.00% and 100.00%, respectively. Conclusion: TCT is a highly accurate screening method, and it is instructive for clinicians to analyze cervical lesions.