Objective: To assess the diagnostic value of combined use of thinprep cytology test( TCT ) with colposcopic biopsy in early screening of cervical lesions. Methods: A total of 5 211 TCT samples were collected from the Tongcheng Municipal People's Hospital and Hospital of TCM of Hexian County between Oct. 2008 and Dec. 2011. By the Bethesda System for reporting cytologic diagnosis, the cases with atypical cells of undetermined significance ( ASCUS ) or more severe cytology were considered positive results, in which 321 cases underwent colposcopic biopsies from multiple sites. Final diagnosis was dependent on histopathologic findings that were compared with the cytologic results. Results: TCT exhibited positive cytology in 396 cases( 7.60% ),ASCUS in 146( 2.80% ),atypical squamous cells( ASC-H ) in 19 ( 0. 36% ),low grade squamous intra-epithelial lesion ( LGSIL or LSIL ) in 167 ( 3. 20% ),high grade squamous intraepithelial lesion ( HGSIL or HSIL ) in 56 ( 1.07% ), squamous cell carcinoma ( SCC ) in 4 ( 0. 08% ) and atypical glandular cells ( AGC ) in another 4( 0. 08% ). As compared with the histopathologic findings,the sensitivity of TCT was 64.49% ( 207/321 ),and the coincidence rate for LSIL,HSIL and SCC were 39. 19%( 58/148 ),83. 33% ( 19/24 ) and 100% ( 1/1 ), respectively. The statistical difference existed significantly concerning the results of detecting cervical intraepithelial ne-oplasia( CIN ) or more severe by combined TCT with colposcopic biopsy for pathological confirmation and simple ( x2 = 10.42 ,v = 4,P <0.01 ). Conclusion: TCT in combination with colposcopic punch biopsy can lead to accurate diagnosis and detectable lesions of cervix, for which is important to early detection and treatment of the cervical cancers as well as prophylaxis.%目的:探讨液基薄层细胞学检测(TCT)联合阴道镜检查在早期宫颈病变筛查中的价值.方法:选择安徽省桐城市人民医院、和县中医院2008年10月～2011年12月间妇科门诊及住院患者和体检妇女行TCT检查满意标本5 211例,ASCUS及以上病变列为细胞学阳性,321例行阴道镜下多点活检,以组织病理学结果为判断标准,将细胞学结果与组织病理学结果作对照分析.结果:TCT结果显示细胞学阳性396例(7.60%),ASC-US 146例,占2.80%;ASC-H 19例,占0.36%;LSIL 167例,占3.20%;HSIL 56例,占1.07%;SCC 4例,占0.08%;AGC 4例,占0.08%.与病理组织学对照,TCT细胞学检查敏感度为64.49%(207/321),符合率在LSIL为39.19%(58/148),HSIL为83.33%(19/24),SCC为100%(1/1).TCT联合阴道镜下活检病理学诊断CIN及以上级别病变与TCT细胞学诊断相比差异有统计学意义(χ2=10.42,υ=4,P<0.01).结论:采用宫颈液基细胞学检查配合阴道镜下多点活组织病理检查,可提高宫颈癌及癌前病变检出率及准确性,对宫颈癌的早期预防、早期发现、早期治疗具有积极临床意义.
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