摘要
目的分析了解传统巴氏涂片(conventional Pap smears,CPS)与液基细胞学(liquid-based cytology,LBC)筛查宫颈癌阳性率的差异与临床意义。方法收集2008年至2015年期间,山东省900余家医院和体检中心送济南金域医学检验中心病理室进行宫颈癌筛查的100 066份CPS标本和997 162份LBC标本的细胞学判读和组织学活检数据,并对两种方法筛查阳性率进行回顾性比较分析。结果 2008和2009年,CPS标本较少(192份,209份),其阳性率与LBC比较,差异无统计学意义(χ~2=0.078,0.023,P>0.05),2010至2015年期间的LBC总阳性率明显高于CPS(χ~2分别为8.32、128.02、131.43、525.88、578.59、209.82,P均<0.01),LBC阳性率分别为CPS的1.6倍、2.66倍、2.47倍、2.72倍、2.52倍和1.63倍。不同细胞病变平均年龄比较,结果显示有明显差异(F=193.28,P<0.001)。随后两两比较结果显示,高级别鳞状上皮内病变(high grade squamous intraepithelial lesions,HSIL)的发病年龄,比低级别鳞状上皮内病变(low grade squamous intraepithelial lesions,LSIL)高3.9岁(P<0.05);宫颈癌的发病年龄比LSIL高8.2岁(P<0.05),比HSIL高4.3岁(P<0.05)。除癌外,LBC判读为不能明确意义的非典型鳞状细胞(atypical squamous cells of unknown significance,ASC-US)、不排除高级别鳞状上皮内病变的非典型鳞状细胞(atypical squamous cells cannot exclude HSIL,ASC-H)、LSIL、HSIL、非典型腺细胞(atypical glandular cells,AGC)和总的阳性率分别为CPS的2.0倍、1.6倍、2.9倍、2.9倍、5.0倍和2.2倍(χ~2分别为784.82、33.01、447.28、217.66、3.79、26.3,P均<0.001);CPS的ASC/SIL比值为3.16,明显高于LBC的2.14,且两种方法的ASC与SIL分布差异具有统计学意义(χ~2=60.91,P<0.001)。液基细胞学判读为ASC-H、HISL和癌,需要组织学活检的患者中,活检为CINⅡ/Ⅲ和癌的比率分别为57.22%(103/108)、84.70%(393/464)和100%(17/17),而CPS未追踪到任何活检结果。结论本研究的LBC阳性率明显高于CPS。LBC是宫颈癌的理�
Objective To compare the reporting rates in conventional Pap smears （CPS） and liquid-based cytology （LBC）, and to show the efficiency of the two methods in the cervical screening. Methods From 2008 to 2015, 100 066 cases of CPS and 997 162 cases of LBC were obtained from more than 900 hospitals and medical centers in Shandong province, and sent to the department of pathology, Jinan Kingmed Diagnostics for Pap staining and cytological diagnosis. The Pap reports and histopathologic follow-up results were retrospectively analyzed. Results The positive results reported with in CPS and LBC were similar in 2008 and 2009, and this might be due to the small sample size of CPS. The total reporting rates of LBC in 2010, 2011, 2012, 2013, 2014 and 2015 were 1.6, 2.66, 2.47, 2.72, 2.52 and 1.63 times higher than those of CPS, respectively （χ^2=8.32, 128.02, 131.43, 525.88, 578.59, 209.82, all P〈0.01）. Comparison among the average ages of different cytologically interpretated lesions demonstrated obvious differences （F=193.28,P〈0.001）. Post hoc analysis showed that the average age of the patient with high grade squamous intraepithelial lesions （HSIL） was 3.9 years older than that with low-grade squamous intraepithelial lesions （LSIL） （P〈0.05）, and the average age of the patient suffer cervical cancer was 8.2 years older than that with LSIL （P〈0.05）, and 4.3 years older than that with HSIL （P〈0.05）. Except for the cancer cases, the rates of atypical squamous cells of unknown significance （ASC-US）, atypical squamous cells that cannot exclude HSIL （ASC-H）, LSIL, HSIL, atypical glandular cells （AGC） and the total positive rate of LBC were 2.0, 1.6, 2.9, 2.9, 5.0, 2.2 times higher than those of CPS, respectively （χ^2 =784.82, 33.01, 447.28, 217.66, 3.79, 26.3, P〈0.001）. The ASC/SIL ratio of CPS and LBC were 3.16, 2.14, respectively. The distribution of ASC and SIL was significantly different when using the two methods （χ^2=60.91, P 〈 0.001）. Histopathologic C
出处
《中华临床实验室管理电子杂志》
2017年第2期98-102,共5页
Chinese Journal of Clinical Laboratory Management(Electronic Edition）
关键词
宫颈癌
液基细胞学
巴氏涂片
筛查
Cervical cancer
Liquid-based cytology
Conventional Pap smears
Screening
