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目的探讨液基超薄细胞技术用于宫颈病变预防与筛查方面具有的临床诊断价值和社会价值。方法随机选取深圳博爱医院及北京四季康医院2007年06月至2008年07月妇科门诊就诊的10 126例患者,利用液基超薄细胞检测系统(TCT),根据《子宫颈细胞学Bethesda报告系统》(TBS)判断标准,做出诊断。将诊断意义不明确的不典型鳞状细胞(ASCUS)以上病变均列为阳性病例,且在阴道镜下行活检,将细胞学检测结果与活检结果作对比分析。结果10 126例标本中,发现异常涂片622例,其中不典型鳞状细胞(ASC-US)264例;低度鳞状上皮内病变(LSIL)257例:高度鳞状上皮内病变(HSIL)69例,7例鳞状细胞癌(SCC);1 598例为HPV感染;滴虫感染165例;霉菌感染541例;细菌感染209例;有炎性反应性细胞改变的8 419例。宫颈病变与年龄段有一定的关系。细胞学与组织病理检查符合率分别为LSIL 78.99%,HSIL95.65%,SCC 100%。因就诊目的不同而分组,其筛查阳性率组间比较差异无统计学意义(P>0.05)。结论利用TCT技术结合TBS进行宫颈疾病普查,对于预防宫颈癌,筛查早期病变,进行早期治疗提供了很好的诊断依据,具有很高的临床诊断价值及社会价值。
Objective To investigate the clinical diagnostic value and social value of liquid-based ultrathin cells for the prevention and screening of cervical lesions. Methods A total of 10 126 patients from Shenzhen Pok Oi Hospital and Beijing Sijikang Hospital from June 2007 to July 2008 were selected by using the TCT system. According to the “Bethesda Reporting System of Cervical Cytology” "(TBS) criteria to make a diagnosis. The above lesions with undefined diagnosis of atypical squamous cells (ASCUS) were all classified as positive cases, biopsy was performed under colposcopy, and the results of cytology and biopsy were compared. Results A total of 622 cases of abnormal smears (ASC-US) were found in 10 126 specimens. There were 257 cases of low grade squamous intraepithelial lesion (LSIL): high grade squamous intraepithelial lesion (HSIL) 69 cases, 7 cases of squamous cell carcinoma (SCC); 1 598 cases of HPV infection; trichomoniasis in 165 cases; 541 cases of mold infection; bacterial infection in 209 cases; 8 419 cases of inflammatory reactive cells. Cervical lesions and age have a certain relationship. The coincidence rates of cytology and histopathology were LSIL 78.99%, HSIL 95.65% and SCC 100% respectively. Due to the different purpose of treatment, the screening positive rate was no significant difference between groups (P> 0.05). Conclusion TCT combined with TBS for cervical disease screening, for the prevention of cervical cancer, screening for early lesions, early treatment provides a good basis for diagnosis, with high clinical diagnostic value and social value.