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目的探讨应用液基薄层细胞学(TCT)检查联合阴道镜下宫颈活检的病理诊断结果对临床宫颈疾病的病因诊治方案提供的价值。方法对3003例受检者的宫颈脱落细胞行膜式液基薄层细胞学(TCT)检查和TBS分类诊断,细胞学阳性者行阴道镜下宫颈多点活检,并行病理组织学检查。结果3003例标本中,76例标本不满意,不满意率2.53%。剩余2927例中无上皮内病变或恶性病变(NILM)伴或不伴炎症者2748例(93.88%);意义不明的非典型鳞状细胞(ASCUS)73例(2.49%);不除外高度鳞状上皮内病变的非典型鳞状细胞(ASC-H)10例(0.34%);低度鳞状上皮内病变(LSIL)75例(2.56%);高度鳞状上皮内病变(HSIL)14例(0.48%);鳞状上皮癌(SCC)6例(0.20%);非特异性的不典型腺细胞(AGC)1例(0.03%)。在微生物检查中:菌群变化,提示细菌性阴道病患者265例,检出率(9.05%);真菌,形态学上符合念珠菌属患者129例,检出率(4.41%);提示疱疹病毒感染者1例,检出率(0.03%);滴虫10例,检出率(0.34%);与病理组织学对照:慢性炎伴挖空细胞或CINⅠ级54例(1.84%);CINⅡ级49例(1.67%);CINⅢ级11例(0.38%);SCC9例(0.31%)。结论TCT技术联合宫颈活检病理组织学结果对临床病因诊治方案提供重要依据,具有重要价值。
Objective To investigate the value of combined diagnosis of pathological diagnosis of cervical diseases by liquid-based thin-layer cytology (TCT) combined with colposcopic biopsy. Methods 3003 cases of cervical exfoliated cells underwent liquid-based thin-layer cytology (TCT) and TBS classification. Positive cytology patients underwent colposcopic multi-biopsy with colposcopy and histopathological examination. Results Of the 3003 specimens, 76 specimens were not satisfied with unsatisfactory rate of 2.53%. There were 2748 cases (93.88%) of the remaining 2927 cases without epithelial or malignant transformation (NILM) with or without inflammation, 73 cases (2.49%) with atypical unspecified atypical squamous cell carcinoma (ASCUS) (ASC-H) in 10 cases (0.34%), low grade squamous intraepithelial lesion (LSIL) in 75 cases (2.56%) and high grade squamous intraepithelial lesion (HSIL) in 14 cases 0.48%); squamous cell carcinoma (SCC) in 6 cases (0.20%); nonspecific atypical gland cells (AGC) in 1 case (0.03%). In the microbiological examination: the flora changed, suggesting that 265 cases of bacterial vaginosis, the detection rate (9.05%); fungi, morphologically consistent with Candida patients in 129 cases, the detection rate (4.41%); prompted herpes virus 1 case of infection, the detection rate (0.03%); trichomoniasis 10 cases, the detection rate (0.34%); with histopathology control: chronic inflammation with hollow cells or CIN Ⅰ 54 cases (1.84% 49 cases (1.67%), 11 cases of CINⅢ (0.38%) and 9 cases of SCC (0.31%). Conclusion TCT combined with cervical biopsy histopathology results provide an important basis for the diagnosis and treatment of clinical etiology, which is of great value.