膜式薄层液基细胞学检查联合初善仪在子宫颈癌前病变诊断中的应用

摘要

目的 探讨膜式薄层液基细胞学检查(thinprep cytologic test,TCT)联合初善仪(truscreen,TS)在子宫颈癌前病变诊断中的应用价值.方法 对30例阴道分泌物异常的患者同时行TCT和TS检查,再行阴道镜检查及组织活检,以组织病理学检查结果作为诊断的金标准.比较2种检查方法单独及联合使用与组织病理学检查结果的吻合程度.结果 30例患者中有25例病理学诊断为子宫颈上皮内瘤变1级及以上病变,为真阳性.TCT测试细胞学意义不明的不典型鳞状上皮细胞以上的阳性19例(63.3%),假阴性6例,漏诊率20.0%,真阳性16例,敏感度84.2%.TS测试阳性18例(60.0%),假阴性7例,漏诊率23.3%,真阳性14例,敏感度77.8%.TCT联合TS测试阳性27例(90.0%),假阴性1例,漏诊率3.3%,真阳性24例,敏感度88.9%.TCT联合TS检测子宫颈癌前病变的阳性率与病理学检查的阳性率分别为90.0%和83.3%,差异无统计学意义(P>0.05).结论 TCT联合TS检查诊断子宫颈癌前病变的准确性明显优于任一单项检查,其漏诊率显著下降.%Objective: To investigate the application value of thinprep cytology test(TCT) combined truscreen(TS) in early diagnosis cervical precancerous lesions. Methods:Thirty patients with abnormal vaginal secretions were detected under TCT and TS,and then vaginal tissue biopsies were tested under colposcopy. The results of pathological examination acted as the gold standard of diagnosis. The match degrees of single and combined using methods and histopathological examination results were compared. Results: The results of histopathological examination of 25 cases were cervical intraepithelial neoplasia grade 1 or above. Nineteen cases(63. 3% ) were ASCUS cytology positive,6 cases were false negative,16 cases were true postive,the rate of fail to diagnosis was 20.0% ,and the sensitiveness degree was 84. 2% under TCT. Compared with TCT results,the data were 18 cases(60. 0% ) ,7 cases, 14 cases,23. 3% and 77. 8% under TS respectively. Compared with TCT or TS results,the data were 27 cases(90. 0% ) ,1 case,24 cases,3. 3% and 88. 9% under TCT and TS respectively. The positive rates of pathology examination and TCT combined with TS inspection was 90. 0% and 83. 3% respectively, the difference had not statistical significance( P >0. 05) . Conclusions: The accuracy of TCT combined with TS inspection for diagnosing cervical precancerous lesions is better than any one single examination, and its rate of fail to diagnosis declined significantly.