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目的:评价不同细胞学检查方法在宫颈癌筛查中的作用,探讨宫颈癌筛查的适宜技术,以便做到早诊、早治,有效提高宫颈癌前病变的检出率。方法:采用液基薄层细胞学检测技术(LCT)及传统宫颈细胞涂片(巴氏涂片)法,分别对2005年10月～2007年6月1 091名及4 784名受检者进行宫颈癌筛查,根据细胞学结果阳性的受检者,在阴道镜下取活体组织检查(活检)行病理学检查。结果:传统细胞学涂片和液基细胞学的灵敏度、特异度、阴性预测值、阳性预测值、符合率分别为:44.44%、83.33%、30.00%、90.32%、77.95%和92.10%、88.37%、77.78、96.20%、89.52%;液基细胞学对子宫颈癌前病变的检出率(91.67%)高于巴氏涂片(40.00%),差异有统计学意义(P<0.05)。结论:液基细胞学检查敏感性明显高于传统宫颈细胞涂片法,能大大提高检出率,尤其是对LSIL和HSIL的患者。
OBJECTIVE: To evaluate the role of different cytological methods in cervical cancer screening and to explore appropriate techniques for cervical cancer screening in order to achieve early diagnosis and early treatment, and to effectively improve the detection rate of cervical precancerous lesions. Methods: A total of 1 091 and 4 784 subjects from October 2005 to June 2007 were studied by liquid-based TLCT and traditional Pap smear (Pap smear) Cervical cancer screening, according to cytology results were positive subjects under colposcopy biopsy (biopsy) line pathology. Results: The sensitivity, specificity, negative predictive value and positive predictive value of cytology smears and liquid-based cytology were 44.44%, 83.33%, 30.00%, 90.32%, 77.95% and 92.10%, 88.37 %, 77.78,96.20% and 89.52% respectively. The detection rate of liquid-based cytology in cervical precancerous lesions was 91.67% higher than that in Pap smear (40.00%), the difference was statistically significant (P <0.05). Conclusion: The sensitivity of liquid-based cytology was significantly higher than that of traditional cervical smear, which can greatly improve the detection rate, especially for patients with LSIL and HSIL.