TCT聯合陰道鏡在宮頸病變中的臨床應用價值
婦幼醫學
作者：曾憲靜 黃素芬
[摘要] 目的 探討TCT聯合陰道鏡在宮頸病變中的臨床應用價值。 方法 2012年1月～2014年7月對在我院婦科門診就診的3785例婦女進行液基薄層細胞學檢測（liquid-based thinPrep cytology test，TCT），然後對液基薄層細胞學陽性（ASCUS、AGCUS以上）患者行陰道鏡檢查，陰道鏡結果異常者行陰道鏡下宮頸活檢。 結果 3785例TCT檢查患者中，ASCUS及以上2067例，占54.6%。其中ASCUS 825例，ASC-H 691例，LSIL 315例，HSIL 207例。2067例TCT檢查陽性患者，行陰道鏡下檢查，其中398例行陰道鏡下宮頸活檢，病理結果報告：慢性宮頸炎136例，ClNⅠ171例，CIN Ⅱ27例，CIN Ⅲ41例，鱗癌20例，腺癌3例，TCT聯合陰道鏡檢查診斷準確率為65.8%。結論 TCT聯合陰道鏡檢查能提高宮頸病變的診斷準確性，大幅減少活檢率，降低漏診率和誤診率，有利於宮頸癌的早期防治。
[關鍵詞] TCT 陰道鏡； 宮頸病變； 病理檢查
[中圖分類號] R713 [文獻標識碼] B [文章編號] 1673-9701（2015）09-0038-03
Clinical applications of colposcopy combined with TCT in cervical lesion screening
ZENG Xianjing HUANG Sufen
Department of gynecology and obstetrics， Haicheng City Central Hospital in Liaoning Province， Haicheng 114200，China
[Abstract] Objective To study clinical application value of colposcopy combined with liquid-based thin prep cytology test（TCT） in cervical lesion screening. Methods TCT was employed to screen cervical lesion of 3785 women cases who came to our hospital to see their doctors from January， 2012 to July， 2014， then colposcopy was performed when the TCT revealed abnormal cervical lesions（grade above ASCUS，AGCUS）， and the biopsy based on colposcopy and pathological examination were performed on the positive cases in colposcopy. Results TCT results revealed that there were 2067 cases（54.6%） that their TBS grade were above ASCUS in 3785 cases， including 825 cases of atypical squamous cells of undetermined significance （ASCUS），691 cases of atypical squamous cells cannot exclude high grade intraepithelial lesions（ASC-H）.315 cases of low grade squamous intraepithelial lesions（LSIL），207 cases of high grade squamous intraepithelial lesion（HSIL）. Colposcopy were performed on the abnormal 2067 cases， and among them 398 abnormal cases were examined by the biopsy based on colposcopy and pathological examination. Examination results showed that there were 136 cases of chronic cervicitis， 171 cases of CINⅠ， 27 cases of CIN Ⅱ， 41 cases of CIN Ⅲ， 20 cases of squamous cell carcinoma （SCC）， 3 cases of adenomatous carcinoma. The total consistent rates of diagnosis between colposcopy combined with TCT and pathological examination were 65.8%. Conclusion Clinical applications showed that colposcopy combined with TCT could improve diagnostic rates， drastically reduce amount of biopsy， decrease rates of missed diagnosis and misdiagnosis and benefit early prevention of treatment of cervical cancers.
[Key words] TCT colposcopy； Cervical lesion； Pathological examination