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目的:探讨宫颈液基细胞学检测系统(LCT)联合阴道镜下组织病理学检查对宫颈病变的筛查价值。方法:收集2009年12月～2010年8月上海交通大学附属新华医院妇科门诊783例宫颈病变患者进行LCT检查,其中52例LCT细胞学阳性患者于阴道镜下取多点活组织病理细胞学检查。结果:慢性宫颈炎21例,占40.4%,CIN I级15例,占28.8%,CIN II级11例,占21.2%,CIN III级4例,占7.7%,宫颈癌1例,占1.9%。其中ASC诊断符合率为73.1%(19/26),LSIL诊断符合率为69.2%(9/13),HSIL诊断符合率为88.9%(8/9),SCC诊断符合率为100.0%(1/1)。结论:LCT技术能明显提高异常细胞的检出率,可作为宫颈癌前病变的常规筛查;阴道镜可基本确定宫颈病变的部位,提高宫颈活检的阳性率,故LCT联合阴道镜检查能够显著提高宫颈病变的早期检出率,为患者宫颈疾病的早期诊断、早期治疗提供科学的依据。
Objective: To investigate the cervical cytology detection system (LCT) combined with colposcopic histopathological examination of cervical lesions screening value. Methods: From December 2009 to August 2010, 783 cases of cervical lesions in gynecology clinic of Xinhua Hospital Affiliated to Shanghai Jiao Tong University were examined by LCT. Fifty-two patients with positive LCT cytology underwent colposcopic biopsy under colposcopy . Results: Chronic cervicitis was found in 21 cases (40.4%), CIN I grade in 15 cases (28.8%), CIN II grade in 11 cases (21.2%), CIN III grade in 4 cases (7.7%) and cervical cancer in 1 case (1.9% . The coincidence rate of ASC diagnosis was 73.1% (19/26), LSIL diagnosis coincidence rate was 69.2% (9/13), HSIL diagnosis coincidence rate was 88.9% (8/9), SCC diagnosis coincidence rate was 100.0% (1 / 1). Conclusion LCT can significantly improve the detection rate of abnormal cells and can be used as a routine screening of precancerous lesions of cervix. Colposcopy can basically determine the location of cervical lesions and improve the positive rate of cervical biopsy, so LCT combined with colposcopy can significantly Improve the early detection rate of cervical lesions for the early diagnosis of cervical disease, early treatment provides a scientific basis.