摘要
目的回顾宫颈液基细胞学检查(TCT)中假阴性病例,分析产生假阴性的原因。方法分析92例病理结果阳性而TCT结果阴性病例的TCT涂片,分别记录其细胞量、有无颈管细胞或化生细胞、是否为出血涂片、是否重度炎症、病灶与宫颈管距离及其组织病理结果。结果原细胞学诊断阴性复查为阳性、细胞量<40%、无颈管细胞或化生细胞、出血涂片、重度炎症、病灶与宫颈管距离>1cm者,在假阴性病例中分别占7.61%、8.70%、11.96%、27.17%、22.82%、21.74%。有血涂片和无血涂片的TCT结果比较,差异有统计学意义(χ2=34.040,P=0.000)。结论获取满意的宫颈细胞样本、改进标本处理、认识到病灶的特殊性以及加强细胞学医师的学习和提高自身诊断水平是降低TCT假阴性的有效方法 ,临床医师对症状体征可疑但细胞学阴性的病例采取阴道镜下多点活检可减少漏诊的发生。
Objective To review the false-negative cases in cervical liquid based cytological test and analyze the causes of the false-negative results.Methods The outcome of 92 cases,with negative result in cytological diagnosis but positive in biopsy diagnosis,were retrospectively analyzed.Cell amount,endocervical column cells,metaplastic cells,smear with blood cells,serious inflammation and distance from the lesion to endocervical tube were recorded in all the cases.Results The positive cases after review,cellular rate less than 40%,Absence of endocervical transformation zone,stain with blood cell,serious inflammation and distance from the lesion to endocervical tube were 7.61%,8.70%,11.96%,27.17%,22.82%,and 21.74%,respectively.The test of TCT has significant difference between smear with blood cells and smear without blood cells（χ^2=34.040,P=0.000）.Conclusion A satisfied cytological smear,the improvement of smear preparation,understanding the particularity of the disease and skill of cytologists in diagnosis are critical to decrease the rate of false-negative results.It＇s important that gynecologis do multiple biopsies under vaginoscope to the patients who are suspicious of cancer but negative cytology.
出处
《中华全科医学》
2010年第9期1113-1114,共2页
Chinese Journal of General Practice
关键词
液基细胞学检查
假阴性
宫颈疾病
Liquid based cytological test
False-negative
Cervical disease
