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目的:调查宫颈液基细胞学检测中颈管细胞(EC)和化生鳞状上皮细胞(MSC)的有无是否与鳞状上皮内瘤变的检出相关,并分析EC和MSC的有无与经活体组织检查(活检)证实的病理结果之间的关系。方法:2008年1月～2010年12月17 815例宫颈液基细胞学涂片被列入研究。将液基细胞学标本中的上皮细胞成分与筛查结果进行统计,比较不同细胞成分下ASCUS、LSIL和HSIL的检出率,并对细胞成分与宫颈活检结果的关系进行分析。结果:总体中ASCUS检出率为4.95%,60～69岁组检出率最高(9.55%);LSIL总检出率为0.27%,40～49岁组检出率最高(0.42%);HSIL总检出率为0.19%,40～49组检出率最高(0.36%)。各年龄组细胞学异常总检出率均以EC(+)/MSC(+)组为最高,其次是EC(-)/MSC(+)组;ASCUS、LSIL及HSIL三组中经病理活检结果证实为CIN2及以上者比例最高组均为EC(-)/MSC(+),三组中所占比例分别为27.41%、50.00%、83.33%;EC(+)/MSC(+)次之,三组中所占比例分别为12.43%、42.85%、80.00%;结论:EC及MSC存在状态对宫颈细胞学异常的总检出率有影响,其中MSC与HSIL之间的关联更强。
OBJECTIVE: To investigate whether cervical canal cells (ECs) and metaplastic squamous cells (MSC) are correlated with the detection of squamous intraepithelial neoplasia in cervical liquid-based cytology and analyze the presence or absence of EC and MSC And biopsy confirmed by the biopsy of the relationship between the pathological results. METHODS: From January 2008 to December 2010 17 815 cervical liquid-based cytology smears were included in the study. The statistics of epithelial cell components and screening results in liquid-based cytology specimens were compared. The detection rates of ASCUS, LSIL and HSIL in different cell components were compared, and the relationship between cell components and cervical biopsy results was analyzed. Results: The overall detection rate of ASCUS was 4.95%, the highest detection rate was 9.55% in 60-69 years old group; the detection rate of LSIL was 0.27% and the highest detection rate was 0.42% in 40-49 years old group; HSIL The total detection rate was 0.19%, 40 ~ 49 group the highest detection rate (0.36%). The total detection rate of cytology abnormality in each age group was the highest in EC (+) / MSC (+) group, followed by EC (-) / MSC (+) group. The pathological biopsy results in ASCUS, LSIL and HSIL EC (+) / MSC (+) was the highest proportion of patients with CIN2 and above, and the proportions of the three groups were 27.41%, 50.00% and 83.33% The proportions of the three groups were 12.43%, 42.85% and 80.00% respectively. CONCLUSION: The presence of EC and MSC has an impact on the overall detection rate of cervical cytology abnormality, and the correlation between MSC and HSIL is stronger.