兰陵地区子宫颈液基细胞学筛查结果分析

摘要

目的：收集和分析兰陵地区子宫颈癌筛查结果，为子宫颈癌防治提供科学依据。方法以2015年上半年兰陵地区已婚女性入组研究，收集子宫颈脱落细胞标本，采用液基细胞学制片，巴氏染色，在严格诊断质量控制下按子宫颈细胞学Bethesda报告系统的诊断标准进行判读。结果收集标本13832例，标本满意率达99.96%。微生物检出情况：真菌感染99例（0.72%），滴虫感染120例（0.87%），放线菌感染30例（0.22%），细菌性阴道病770例（5.57%），共1019例（7.37%）。子宫颈液基细胞学检测（liquid-based cytology testing，LCT）情况：不能明确意义的不典型鳞状细胞（atypical squamous cells of unknown significance，ASC-US）479例（3.46%），不除外高级别鳞状上皮内病变的不典型鳞状上皮细胞（atypical squamous cells cannot exclude HSIL，ASC-H）25例（0.18%），低级别鳞状上皮内病变（low grade squamous intraepithelial lesions ，LSIL）235例（1.70%），高级别鳞状上皮内病变（high grade squamous intraepithelial lesions ，HSIL）90例（0.65%），鳞状细胞癌（squamous cell carcinomas，SCC）1例（0.01%），不典型腺细胞（atypical glandular cells，AGC）4例（0.03%）。细胞学检查异常共834例，占6.03%。细胞学检查异常人群集中在25~55岁。诊断质量控制结果：不典型鳞状上皮细胞与上皮内病变的比值（ASC/SIL）为1.546；27例HSIL宫颈活检病理结果显示26例为子宫颈上皮内瘤变（ cervical intraepithelial neoplasia，CIN）Ⅱ级、Ⅲ级，符合率为96.3%。结论子宫颈液基细胞学检测能发现子宫颈微生物感染及癌前病变，为子宫颈癌筛查工作提供科学依据。%Objective To screen married women in Lanling District for cervical cancer using liquid-based cytology testing(LCT). Methods Married women in Lanling district were enrolled into this study in the first half of 2015 based on stratified cluster sampling. Samples were stained by the pap method,analyzed by LCT and diagnosed based on the Tethesda system. Results Screening was completed for 99.96%of the 13,832 samples. Of the 13,832 samples analyzed,90 (0.72%)showed Candida albicans infection;120 (0.87%),vaginal trichomoniasis;30(0.22%),actinomycosis;and 770(5.57%),bacterial vaginosis. A total of 1,019 women(7.37%) showed microbial infections and 834(6.03%)showed cell abnormalities. Women with such abnormalities,most of whom were between 25 and 55 years old,included 479(3.46%)with atypical squamous cells(ASC)of unknown significance(ASC-US),25(0.18%) with atypical squamous cells that might correspond to high-grade squamous intraepithelial lesions(HSIL,ASC-H),235(1.70%)with low-grade squamous intraepithelial lesions(LSIL),90(0.65%)with HSIL,1(0.01%)with squamous cell carcinoma(SCC)and 4 (0.03%)with atypical glandular cells(AGC). The ratio of ASC to squamous intraepithelial lesions was 1.546. Cervical biopsy showed that 26 of the 27 women with HSIL had cervical intraepithelial neoplasia Ⅱ or Ⅲ. The diagnostic coincidence rate was 96.3%. Conclusion Cervical LCT can detect a large number of microbial infections and precancerous lesions,suggesting it is effective for cervical cancer screening of married women.