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目的评价液基薄层细胞学(TCT)检查与阴道镜下活检,进行病理组织学检查,在宫颈病变诊断中的价值。方法对2009年11月～2010年10月在三亚市妇幼保健院门诊与妇科体检的4 860例患者做TCT检查。细胞学诊断采用TBS分级系统,将不典型鳞状细胞(ASCUS)以上病变均列为阳性病例,对阳性病例进一步采用阴道镜下活检。结果 4 860例TCT诊断阳性患者446例占9.17%,其中ASCUS 361例占7.43%,低度鳞状上皮内病变(LSIL)70例占1.44%,高度鳞状上皮内病变(HSIL)11例占0.22%,鳞状细胞癌(SCC)4例占0.08%。阳性病例全部在阴道镜下取活检。病理组织学诊断宫颈上皮内瘤变(CIN)197例,其中CIN I 169例,CIN II 20例,CIN III 8例。原位癌1例,SCC 7例,宫颈炎症241例。结论 TCT用于宫颈早期病变的筛查是目前最好的筛查方法,而TCT联合阴道镜下活检可提高宫颈病变的检出率及准确率。
Objective To evaluate the value of thin-section cytology (TCT) and colposcopy biopsy for pathological examination in the diagnosis of cervical lesions. Methods From November 2009 to October 2010 in Sanya Maternal and Child Health Hospital outpatient and gynecological examination of 4860 patients with TCT. Cytological diagnosis using TBS grading system, atypical squamous cells (ASCUS) above lesions were classified as positive cases, positive cases further colposcopy biopsy. Results A total of 4460 cases with positive diagnosis of TCT were found in 4,860 cases, accounting for 9.17%, of which 361 cases were ASCUS, accounting for 7.43%, 70 cases with low grade squamous intraepithelial lesion (LSIL) accounting for 1.44%, and 11 cases with highly squamous intraepithelial lesion (HSIL) 0.22%, squamous cell carcinoma (SCC) 4 cases accounted for 0.08%. All positive cases under biopsy colposcopy. The pathological diagnosis of cervical intraepithelial neoplasia (CIN) 197 cases, of which 169 cases of CIN I, CIN II in 20 cases, CIN III in 8 cases. In situ carcinoma in 1 case, SCC in 7 cases, 241 cases of cervical inflammation. Conclusion TCT for early cervical lesions screening is the best screening method, and TCT colposcopy biopsy can improve the detection rate of cervical lesions and accuracy.