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目的:探讨液基细胞学在诊断宫颈病变筛查中的价值。方法:采集2 365例妇女的宫颈脱落细胞,采用液基细胞学检查,细胞诊断采用TBS分级系统。将所有意义不明的不典型鳞状上皮细胞(ASCUS)以上病变均列为阳性病例,并进行阴道镜下活体组织检查(活检)。结果:2365例检出阳性病例74例,其中不典型鳞状上皮细胞48例,低度鳞状上皮内病变12例,高度鳞状上皮内病变13例,不典型腺细胞1例,子宫颈癌未检出。74例阳性病例病理结果:炎症61例,宫颈上皮内瘤变Ⅰ5例,宫颈上皮内瘤变Ⅱ7例,宫颈上皮内瘤变Ⅲ1例。微生物检查项目阳性78例,其中念珠菌感染66例,细菌过度增多11例。病毒检查项目:人类乳头瘤病毒(HPV)感染5例。液基细胞学检查与病理诊断符合率分别为低度鳞状上皮内病变83.33%(10/12),高度鳞状上皮内病变92.31%(12/13)。结论:液基细胞学检查结合阴道镜下活检病理检查是妇女病筛查和诊断宫颈癌前病变的可靠手段。
Objective: To investigate the value of liquid-based cytology in the diagnosis of cervical lesions screening. METHODS: Cervical exfoliated cells were collected from 2 365 women using liquid-based cytology and TBS grading system for cell diagnosis. All of the above unknown lesions of atypical squamous cell carcinoma (ASCUS) were classified as positive cases, and colposcopic biopsy was performed. Results: Of 2365 positive cases detected in 74 cases, including atypical squamous cell in 48 cases, low grade squamous intraepithelial lesion in 12 cases, high grade squamous intraepithelial lesion in 13 cases, atypical glandular cell in 1 case, cervical cancer not Check out. Pathological results of 74 cases of positive cases: inflammation in 61 cases, cervical intraepithelial neoplasia Ⅰ 5 cases, cervical intraepithelial neoplasia Ⅱ in 7 cases, cervical intraepithelial neoplasia in 1 case. 78 cases were positive for microbiological examination, including 66 cases of candida infection and 11 cases of excessive bacterial growth. Virus test items: human papillomavirus (HPV) infection in 5 cases. The coincidence rate of liquid-based cytology and pathological diagnosis was 83.33% (10/12) in low-grade squamous intraepithelial lesion and 92.31% (12/13) in highly squamous intraepithelial lesion. Conclusion: Liquid-based cytology combined with colposcopic biopsy is a reliable method for screening women and diagnosing cervical precancerous lesions.