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目的:探讨液基细胞学检测(TCT),阴道镜下活检对早期宫颈病变的应用,及宫颈高度病变的高危因素。方法:对1 896例早期宫颈病变进行TCT检查,将不典型鳞状细胞(ASCUS)以上病变为阳性。阳性者在阴道镜下活检,作病理学诊断及高危因素分析。结果:TCT阳性病例169例,总检出率8.91%。组织病理检出宫颈上皮内瘤样病变中度(CIN)27例(15.98%);宫颈上皮内瘤样病变重度(CIN)23例(13.61%);癌4例(2.37%);宫颈高度病变的高危因素有:多性伴(≥3人),早婚(<20岁),多产(≥2次),宫颈中、重度糜烂等。结论:宫颈早期病变的临床管理以“细胞学—阴道镜—组织病理”三阶梯治疗为佳,加强TCT结果为ASCUS以上患者及高危因素患者的管理,有效控制宫颈癌的发生,从而提高妇女健康水平。
Objective: To investigate the application of liquid-based cytology (TCT), colposcopic biopsy to early cervical lesions and high-risk factors of cervical lesions. Methods: Totally 1896 cases of early cervical lesions were examined by TCT, and the above lesions of atypical squamous cells (ASCUS) were positive. Positive colposcopy biopsy for pathological diagnosis and risk factors analysis. Results: 169 cases of TCT positive cases, the total detection rate of 8.91%. Cervical intraepithelial neoplasia was detected by histopathology in 27 cases (15.98%) with moderate (CIN), 23 cases (13.61%) with cervical intraepithelial neoplasia (CIN), 4 cases (2.37%) with cervical cancer, The risk factors are: polygamy (≥ 3), early marriage (<20 years), prolific (≥ 2 times), cervical erosion, severe erosion. Conclusion: The clinical management of early cervical lesions is better than “cytology-colposcopy-histopathology” three-step therapy, and the management of patients with ASCUS and risk factors should be strengthened to effectively control the occurrence of cervical cancer and improve the TCT result Women’s health level.