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目的:探讨宫颈细胞学巴氏涂片(PAP)和液基薄层细胞技术(TCT)对海岛妇女宫颈癌筛查的诊断价值。方法:对15 425例宫颈癌筛查对象采用PAP和TCT两种方法交替和随机进行细胞学检查并采用TBS分类标准系统进行诊断报告,将细胞学诊断异常者除ASC-US外进行宫颈活检,最后以组织学诊断为金标准,并对结果进行分析。结果:巴氏涂片检查9 058例,细胞学诊断异常169例,异常率为1.87%。液基薄层细胞技术检查6 367例,细胞学诊断异常123例,异常率为1.93%,两者无统计学差异(P>0.05)。巴氏涂片检查的169例细胞学诊断异常者进行宫颈活检91例,经组织学确诊CINⅠ级3例,CINⅡ～Ⅲ级7例,CINⅡ～Ⅲ级累及腺体1例,确诊符合率23.1%。TCT检查的123例细胞学诊断异常者进行宫颈活检57例,经组织学确诊CINⅠ级7例,CINⅡ～Ⅲ级16例,CINⅡ～Ⅲ级累及腺体3例,确诊符合率80.7%,两者具有明显的统计学差异(P<0.05)。结论:TCT筛查宫颈癌及宫颈癌前病变是方便安全、有效可靠且经济的检查方法,尤其适合海岛妇女宫颈癌筛查。
Objective: To investigate the diagnostic value of Pap smear (PAP) and liquid-based thin-layer cytology (TCT) for screening cervical cancer in island women. Methods: A total of 15 425 cases of cervical cancer screening by PAP and TCT two methods alternately and randomly cytology and TBS classification system for diagnostic reports, the cytology diagnosis of abnormal except for ASC-US cervical biopsy, Finally, histological diagnosis as the gold standard, and the results were analyzed. Results: There were 9 058 Pap tests and 169 cytologic abnormalities with an abnormal rate of 1.87%. There were 6 367 liquid-based thin-layer cytological examinations and 123 cytologic abnormalities with an abnormality rate of 1.93%. There was no significant difference between the two (P> 0.05). Ninety-one patients with abnormal cytology diagnosed by Pap smear underwent cervical biopsy. Totally 91 cases were diagnosed by cervical biopsy. There were 3 cases of CINⅠ, 7 cases of CINⅡ ~ Ⅲ and 1 case of CINⅡ ~ Ⅲ involving gland. The coincidence rate was 23.1% . TCT examination of 123 cases of cytological abnormalities in 57 cases of cervical biopsy confirmed by histological CIN Ⅰ grade in 7 cases, CIN Ⅱ ~ Ⅲ grade in 16 cases, CIN Ⅱ ~ Ⅲ grade involving the gland in 3 cases, the confirmed coincidence rate of 80.7%, both There was a significant statistical difference (P <0.05). Conclusion: TCT screening of cervical cancer and precancerous lesions is convenient and safe, effective and reliable and economical method of examination, especially for island women cervical cancer screening.