摘要
目的探讨液基薄层细胞检测系统(TCT)宫颈细胞涂片及阴道镜下宫颈活检对宫颈上皮内瘤变(CIN)的诊断价值。方法回顾性分析哈尔滨医科大学附属肿瘤医院4041例TCT筛查结果及其中308例细胞学阳性行阴道镜下活检的病理结果。结果鳞状上皮内低度病变(LSIL)及鳞状上皮内高度病变(HSIL)的诊断,细胞学检查诊断率高于阴道镜下活检病理学检查。炎症及鳞状细胞癌(SCC)的诊断,阴道镜下活检病理学检查诊断率高于细胞学检查。结论采用TCT筛查可早期发现宫颈病变;细胞学阳性或临床可疑者应配合阴道镜检查及镜下活检可提高CIN的检出率;对TCT呈意义不明确的非典型鳞状细胞(ASC-US)和不除外高度上皮内瘤变的非典型鳞状细胞(ASC-H)的患者进行阴道镜下活检可降低漏诊率。
[Objective] To study the diagnoses value of cervical cell smear produced by fluid based thin-layer cytological test system （TCT） and cervical biopsy punched under the instruction of eolposeopy to the cervical intraepithelial neoplasia（CIN）. [Methods] Retrospective analyze clinical information of 4 041 patients received TCT at Gynecologic Department of the Affdiated Tumour Hospital of Harbin medical university and 308 patients who received multiple punch biopsies because of abnormal cervical cytological specimen or high-grade clinical suspicion. [Results] The diagnosis rate of Low-grade squamous intraepithelial lesion （LSIL） and high-grade squamous intraep- ithelial lesion （HSIL） determined by TCT were evidently higher than that by pathologic examination. The diagnosis rate of inflammation and squamous cell carcinoma （SCC） determined by pathologic examination were evidently higher than that of by TCT. [Conclusions] It may detect cervical lesion in its early stage if fluid based thin-layer cytological test is adopted; The patients whose cytological test are positive or clinical high-grade suspicious should receive directed punch biopsy under colposcopy. These tests may benefit to increase detection rate of CIN and HPV infection; The patients whose TCT smear diagnoses is ASCUS or ASC-H should accept biopsy under the eolposcopy, this may decrease the misdiagonises rate of CIN.
出处
《中国内镜杂志》
CSCD
北大核心
2007年第2期129-131,134,共4页
China Journal of Endoscopy
关键词
液基细胞学
阴道镜
宫颈上皮内瘤变
实验室诊断
fluid based cytology
eolposcopy
cervical intraepithelial neoplasia
lab diagnosis
