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目的探索人群大样本子宫颈癌筛查中宫颈涂片质量控制的方法,提高涂片质量和细胞学检查灵敏度。方法概率比随机抽样,常规加跟踪质量控制,肉眼加镜下观察。观察指标:涂片膜厚度、涂片膜面积、血液成分、鳞状上皮细胞数、有无颈管细胞。结果①2008年项目点的后期涂片质量好于前期。肉眼观察涂片膜厚度、血液成分过多、涂片膜面积<40%3项指标后期较前期分别下降0.25%、4.33%、1.51%;镜下观察鳞状上皮细胞数、血细胞过多2项指标分别下降11.79%、11.95%,未见颈管柱状细胞或化生细胞上升3.51%。②2009年项目点涂片质量高于2008年。肉眼观察血液成分过多、涂片膜面积<40%2项指标分别下降0.55%、0.43%,涂片膜厚上升0.58%;镜下观察鳞状上皮细胞数、未见颈管柱状细胞或化生细胞、血细胞过多3项指标分别下降9.61%、4.71%、1.01%。结论建立简便、易行、科学的质量控制方法,能全面监控宫颈癌筛查的涂片质量,及时发现问题提高宫颈涂片质量。
Objective To explore a method for quality control of cervical smears in large sample cervical cancer screening and to improve smear quality and cytological sensitivity. Method probability than random sampling, conventional plus tracking quality control, the naked eye plus mirror observation. Observations: smear film thickness, smear film area, blood composition, squamous cell number, with or without cervical canal cells. Results ① The smear quality of the post-2008 project was better than that of the previous stage. Macroscopically, the thickness of the smear film was observed with too much blood and the area of the smear film <40% decreased by 0.25%, 4.33% and 1.51%, respectively. The number of squamous cells and hypercytosis The index decreased by 11.79% and 11.95% respectively. No increase of cervical columnar cells or metaplastic cells was observed by 3.51%. ② 2009 project spot smear quality is higher than in 2008. Macroscopic observation of excessive blood components, smear film area <40% of the two indicators decreased by 0.55%, 0.43%, smear thickness increased by 0.58%; microscopically observed squamous cell number, no cervical columnar cells or 3 indicators of raw cells and hyperchromaticity decreased by 9.61%, 4.71% and 1.01% respectively. Conclusion The establishment of simple, easy and scientific quality control methods can fully monitor the smear quality of cervical cancer screening, timely detection of problems to improve the quality of cervical smears.