摘要
目的:通过比较三种常用方法,以期找到子宫颈癌早期筛查的最佳方案。方法:分别采用传统子宫颈细胞涂片、阴道镜检查、液基细胞学检查(TCT)三种常用方法对1692例子宫颈疾病患者进行子宫颈癌筛查。细胞学诊断采用TBS分级系统,阳性诊断包括意义不明的不典型鳞状上皮(A SCU S)以上病变。所有A SCU S以上病变的患者均在阴道镜下活检。以病理检查为金标准,对比这三种方法的敏感性、特异性、准确性、约登指数及K appa值。结果:三种检测方法的敏感性、特异性、准确性、约登指数及K appa值依次为:传统细胞学涂片(20.50%,60.00%,55.60%,0.0780,0.0270);阴道镜检查(33.33%,91.49%,88.00%,0.2482,0.1892);液基细胞学(66.67%,97.87%,96.00%,0.8227,0.6454)。结论:传统子宫颈涂片诊断价值很低,TCT为子宫颈癌早期筛查的可选方法。液基细胞学的TBS诊断法与阴道镜下定位活检,病理检查结合可以显著提高子宫颈癌前病变的诊断准确率。
Objective To explore the best program of the early screening of the cervical cancer. Methods One thousand six hundred and ninety two patients were screened for cervical carcinoma with traditional cervical cells smears, colposcopy and cytologic test. Cell diagnosis adopted TBS-group system thinprep. All the examinations above ASCUS pathological changes were examined with colposcope. Biopsy was a golden standard. Results The sensitivity, specificity, efficiency, Youden＇s index and kappa of each diagnostic test listed respectively as follows, traditional cervical cells smears （20.50%, 60.00%, 55.60%, 0. 0780, 0. 0270）, colposcopy（33.33%, 91.49%, 88.00%, 0. 2482, 0. 1892）, and thinprep Pap （66. 67%, 97. 87%, 96. 00%, 0. 8227, 0. 6454）. Conclusion The diagnostic value of traditional cervical cell smears is very low. Thinprep cytology is suitable for the early screening test of cervical cancer. The combining use of TCT, orientational examination under colposcope and pathological examination can improve the accuracy of identifying cervical lesion.
出处
《实用诊断与治疗杂志》
2006年第4期260-262,共3页
Journal of Practical Diagnosis and Therapy
关键词
子宫颈癌
液基细胞学TBS诊断
阴道镜
Cervical carcinoma
liquid-based cytology
TBS diagnosis
colposcope
