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目的:应用液基薄层细胞学(TCT)检测宫颈病变。方法:2004年2月~2006年12月选择我院宫颈病变中心16 801例进行检查,将诊断意义不明的不典型鳞状细胞(ASCUS)及以上病变均列为细胞阳性病例,并进行阴道镜下多点取材活检,将细胞学结果与活检结果作对照分析。结果:TCT标本满意率为1 658/16 801(98.69%),细胞阳性病例1 561例,总检出率1 561/16 801(9.29%);其中癌29/19 801(0.17%);高度鳞状上皮内病变(HSIL)131/16 801(0.78%);低度鳞状上皮内病变(LSIL)609/1 6801(3.62%);不除外高度鳞状上皮内病变的不典型鳞状细胞(ASC-H)97/16 801(0.58%);ASC-US及AGUS共695/1 6801(4.14%)。对1561例TCT阳性者进行病理检查:宫颈癌和癌前病变的阳性率和准确率分别是CA 29/29(100%),29/29(100%);HSIL 131/131(100%),121/131(92.37%);LSIL 409/609(67.16%),349/609(57.31%);ASC-H 53/97(54.64%),29/97(29.90%);ASC-US+AGUS病理阳性率是98/695(14.1%)。经组织学确诊的患者按不同年龄分段后,发现C IN及CA发生在21~30岁发病率高于31~40岁及41~50岁(2χ=8.682 0,P=0.033 8;2χ=10.557 6,P=0.014 4);31~40岁及41~50岁无统计学意义(2χ=1.637 2,P=0.651 0),提示宫颈癌发病有年轻化趋势。结论:宫颈疾病趋向年轻化,发病率高,新柏氏TCT系统可提高宫颈病变的检测率及准确性。
Objective: To detect cervical lesions by liquid-based thin-layer cytology (TCT). Methods: From February 2004 to December 2006, 16 801 cervical center of cervix in our hospital were selected for examination. The atypical squamous cell carcinoma (ASCUS) and the above lesions with unknown significance were all classified as cell positive cases and colposcopy Under the multi-point biopsy, cytology and biopsy results for controlled analysis. Results: The satisfaction rate of TCT specimens was 1 658/16 801 (98.69%). There were 1 561 positive cases with a total detection rate of 1 561/16 801 (9.29%), including 29/19 801 (0.17%) of cancers, Squamous intraepithelial lesions (HSIL) 131/16 801 (0.78%); low grade squamous intraepithelial lesions (LSIL) 609/1 6801 (3.62%); atypical squamous cells (ASC-H) 97/16 801 (0.58%); ASC-US and AGUS total 695/1 6801 (4.14%). The positive rates of cervical cancer and precancerous lesions in 1561 TCT positive patients were CA 29/29 (100%), 29/29 (100%), HSIL 131/131 (100%), ASC-H + 53/97 (54.64%), 29/97 (29.90%); ASC-US + AGUS pathology The positive rate was 98/695 (14.1%). Histologically diagnosed patients by different age segments, found that C IN and CA occurred in 21 to 30 years old incidence was higher than 31 to 40 years and 41 to 50 years (2χ = 8.682 0, P = 0.033 8; 2χ = 10.557 6, P = 0.014 4). There was no significant difference between 31-40 years old and 41-50 years old (2χ = 1.637 2, P = 0.651 0), which indicated that the incidence of cervical cancer was younger. Conclusion: Cervical disease tends to be younger and the morbidity is higher. Neo-Parker TCT system can improve the detection rate and accuracy of cervical lesions.