摘要
目的探讨妇科体检中应用液基细胞学(TCT)检查结合高危型HPV检测对子宫颈上皮内瘤病变的筛查价值。方法本院2010年1月～2011年12月6973例妇科体检宫颈液基薄层细胞学检查,采用美国新柏氏液基薄层细胞学(TCT)检测系统制片,细胞学诊断采用TBS分级系统。结果 6973例液基薄层细胞学检查结果中,细胞学异常者为372例,阳性检出率为5.33%。372例细胞学检查阳性中,ASCUS286例(包含少量非典型鳞状上皮细胞),占76.88%;LSIL28例,占7.53%;ASCU-H27例,占7.26%;HSIL22例,占5.91%,非典型腺细胞(AGUS)6例,占1.61%,宫颈鳞癌(SCC)3例,占0.81%;对372例TCT阳性患者行HPV分型检测进行分流,286例ASCUS高危型或低危型HPV阳性者中154例进行阴道镜检查,对细胞学结果ASCUS以上的不论HPV检测是否阳性共计240例均进行阴道镜检查后行宫颈组织学活检,诊断CINⅠ～Ⅲ患者126例,其中CINⅠ36例,CINⅡ36例,CINⅢ54例,宫颈鳞癌6例,慢性宫颈炎伴鳞化38例,HPV亚临床感染33例。宫颈上皮内瘤变的病理诊断符合率分别为ASCUS43.97%,LSIL96.55%,ASC-H100%,HSIL96.65%,SCC100%,AGUC33.33%。结论液基薄层细胞学(TCT)检测系统是宫颈上皮内瘤变筛查的一种有效方法,宫颈或阴道炎症、HPV病毒感染都会引起宫颈细胞学的异常,有一定的局限性,对于细胞学检查异常的患者进行HPV病毒检测,即便细胞学异常级别较低,一旦合并高危型HPV病毒感染,也有宫颈上皮内瘤变的发生;TCT阳性、HPV阳性者再进行阴道镜检查取组织学,提高了诊断宫颈上皮内瘤变的符合率,对宫颈上皮内瘤变的及时干预和治疗,能有效预防宫颈癌的发生。
Objective To investigate the gynecological examination of the application of liquid-based cytology （TCT） and check the combination of high-risk HPV detection of cervical intraepithelial neoplasia lesions screening value. Methods From Jan 2010 to Dec 2011,6 973 cases of gynecological examination cervical ThinPrep cytology using ThinPrep liquid-based thin-layer cytology （TCT） detection system producer,cytological diagnosis TBS grading system. Results 6 973 cases of Thin- Prep cyl：ology results,cytologic abnormalities in 372 cases,the positive rate of 5.33%. 372 cases of positive cytology,ASCUS of 286 cases （containing a small amount of atypical squamous cells）,accounting for 76.88% ;LSIL of 28 cases,accounting for 7.53%;ASCU-H of 27 cases,accounting for 7.26%; HSIL of 22 cases,accounting for 5.91%; atypical glandular cells （AGUS） of 6 cases, accounting for 1.61%; cervical squamous call carcinoma （SCC） of 3 cases,accounting for 0.81%;372 cases the TCT- positive patients with HPV genotyping shunt,286 cases of ASCUS high-risk or low-risk HPV-positive 154 cases carried col- poseopy,cytology results of ASCUS or more regardless of HPV detection whether positive total of 240 cases were carried col- poscopy checking underwent cervical tissue science biopsy,the diagnosis of CIN Ⅰ -Ⅲ patients 126 cases,6 cases of cervical squamous cell carcinoma ,chronic cervicitis with squamous metaplasia of 38 cases ,33 cases of HPV subclinical infection. The pathologic diagnosis rate of CIN were ASCUS 43.97%, LSIL 96.55,ASC-H 100% ,HSIL 96.65% ,the SCC 100% ,AGUC 33.33%.Conclusion TCT detection system is an effective method of screening for CIN, cervical or vaginal inflammation, HPV infection will cause abnormal cervical cytology,there are some limitations for cytology abnormalities in patients with the HPV virus detection, even if the lower-level cytological abnormalities. Once the merger is a high-risk types of HPV infection, CIN ;TCT positive for HPV-positive colposcopy take histological improve the compliance rate of diagnosis of CIN, timely intervention and treatment of CIN, can effectively prevent the occurrence of cervical cancer.
出处
《中国现代医药杂志》
2013年第1期51-54,共4页
Modern Medicine Journal of China
关键词
妇科体检
TCT
高危型HPV
宫颈上皮内瘤变
诊断
Gynecological examination TCT High-risk types of HPV Cervical intraepithelial neoplasia （CIN） Di-agnosis
