摘要
目的：探讨液基细胞学（TCT）与初善仪（TS）在宫颈病变筛查中的联合应用价值。方法选择2013年12月～2014年11月就诊于解放军总医院妇科门诊阴道镜室的患者218例,所有患者均给予TCT及TS检查,并根据TCT及TS检查结果进行分组,结合病理学结果分析两种检测方法细胞学诊断价值的差异。结果TCT结果显示,218例患者中,不能明确意义的非典型鳞状细胞（ASC-US）76例,非典型鳞状细胞不除上皮内高度病变（ASC-H）43例,低度鳞状上皮内病变（LSIL）58例,高度鳞状上皮内病变（HSIL）41例；TS检测异常者94例。病理结果正常者106例,LSIL/CIN 141例,HSIL/CIN 2~371例。病理结果正常患者中,细胞学ASC-H与LSIL的检出率分别为53.5%和56.9%；低级别病变患者中,ASC-US和LSIL的检出率显著高于ASC-H及HSIL组（P=0.005）；高级别病变患者中,ASC-H及HSIL的检出率显著高于ASC-US和LSIL（P=0.004）。经TS分层后,TS阴性而病理结果正常的患者中,TCT各组的检出率均提高；TS阳性而病理低级别病变患者中,ASC-US与LSIL的检出率升高,ASC-H与HSIL呈下降趋势,高级别病变患者中,TBS分级四组的检出率均升高。结论联合应用TS可以减少阴道镜门诊的过度转诊并能够更灵敏地发现高级别病变患者。
Objective To investigate the value of TruScreen （TS） combined with Thinprep cytology test in screening of cervical lesions. Methods 218 patients from December 2013 to November 2014 in Outpatient Vaginoscopy Room of PLA General Hospital, all patients were given the detection of TCT and TS, they were divided into different group ac-cording the detection results of TCT and TS, and diagnostic value of TCT and TS were evaluated by pathology result as a golden standard. Results The results of TCT showed that, there were 76 cases of ASC-US, 43 cases of ASC-H, 58 cases of LSIL and 41 cases of HSIL in total of 218 patients; TS showed that 94 cases were abnormal. Pathological re-sults showed that, 41 cases of LSIL/CIN 1 and 71 cases of HSIL/CIN 2-3, other 106 cases were normal. Among cases with normal pathological findings, the positive rate of ASCH and LSIL in cytology was 53.5% and 56.9% respectively. Patients with low grade lesions, the detection rate of ASC-US and LSIL was significantly higher than that of ASC-H and HSIL （P= 0.005）. In cases of high-grade lesions, the positive rate of ASC-H and HSIL was significantly higher than those of ASC-US and LSIL （P=0.004）. After stratification by TS, the detection rate of TCT in each group was im-proved in cases with negative TS findings and normal pathological results. The positive rate of ASC-US and LSIL group increased in cases with positive TS findings and low grade lesion by pathology, ASC-H and HSIL groups composed of a downward trend. Positive rate of 4 groups named by TBS increased in cases with high-grade lesion. Conclusion Combined application of TS can reduce the excessive re-ferral to colposcopy clinics and detect patients with the high grade lesion more sensitively.
出处
《中国医药导报》
CAS
2015年第18期66-70,74,共6页
China Medical Herald
基金
解放军总医院临床科研扶持基金项目(2013FCZHCG-1005)
关键词
宫颈病变
筛查
液基细胞学
初善仪
Cervical lesion
Screening
Thinprep cytol-ogy test
TruScreen
