传统宫颈细胞学检查与液基细胞学检测的比较与评价

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目的:对于宫颈病变的两种检测方法进行比较与评价。方法:对2004年间就诊患者1200例行传统宫颈涂片检查,2005年至2007年间门诊患者10000例行液基细胞学检测(Liquid based cytology test,LCT)。对313例LCT检测结果为“未明确诊断意义的非典型鳞状细胞”(ASCUS)的患者行阴道镜下活组织检查。结果:LCT的标本不满意率0.51%(51/10000)明显低于传统宫颈细胞涂片1.08%(13/1200),同时提高了宫颈癌前病变的检出率。313例LCT检测为ASCUS的患者行阴道镜下活组织检查,病检结果:炎症139例(44.41%),炎症合并HPV感染125例(39.94%),CIN1级25例(7.98%),CIN2级11例(3.52%),CIN3级6例(1.91%),SCC7例(2.24%)。结论:LCT独特的取材与制作方法更有利于宫颈病变的检出。LCT诊断为ASCUS的患者,临床医生应结合患者年龄及阴道镜检查,必要时取活检,以免延误治疗。 Objective: To compare and evaluate two detection methods of cervical lesions. Methods: A total of 1200 traditional cervical smear tests were performed on 1200 patients from 2004 to 2004 and 10000 based liquid-based cytology tests (LCT) were performed in outpatients between 2005 and 2007. Three hundred and seventy patients with LCT test results of “atypical squamous cells of undetermined significance” (ASCUS) underwent colposcopic biopsy. Results: The unsatisfactory rate of LCT was 0.51% (51/10000), which was significantly lower than 1.08% (13/1200) of traditional cervical smears. Meanwhile, the detection rate of cervical precancerous lesions was increased. The results of pathological examination included 139 cases (44.41%) of inflammation, 125 cases (39.94%) of inflammation combined with HPV infection, 25 cases (7.98%) of CIN1 grade, CIN2 grade 11 cases (3.52%), 6 cases (1.91%) of CIN3 grade and 7 cases (2.24%) of SCC. Conclusion: LCT unique material and production method is more conducive to the detection of cervical lesions. LCT diagnosis of ASCUS patients, clinicians should be combined with the patient’s age and colposcopy, biopsy taken when necessary, so as not to delay treatment.
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