文档介绍：LCT在宫颈癌和癌前病变筛查中的应用
作者:王蓁,刘丽芝,王箴言,刘崇芳
[摘要]目的评价Auto Cyteprep液基薄层细胞学技术(LCT)对宫颈癌和癌前病变筛查的准确性。方法2003年1月~2005年1月,我院妇科门诊对14 533例病人分别采用LCT检测系统和传统巴氏涂片进行了宫颈病变的早期筛查。细胞学诊断采用TBS分级系统,阳性诊断包括意义不明的不典型鳞状上皮(ASCUS)及其以上病变。所有阳性诊断的病人均行阴道镜下宫颈活组织病理检查。结果 LCT组标本不满意率明显低于传统涂片组( χ2 = ,P <)。LCT组与传统涂片组比较显著提高了对宫颈高度、低度鳞状上皮内病变(HSIL、LSIL)和ASCUS的阳性检出率( χ2 =~,P <)。LCT组细胞学检查阳性结果(HSIL、LSIL)和病理检查符合率与传统涂片组比较均有显著性差异( χ2 =、,P <)。以病理检查作为标准对照,LCT组与传统涂片组比较,显著提高了对HSIL及LSIL诊断的灵敏度、特异度和阳性预测值( χ2 =~9 ,P <)。结论宫颈细胞学筛查是宫颈癌及癌前病变早期诊断的重要方法。LCT独特的取材与制片方法对检出ASCUS及其以上病变较传统巴氏涂片具有明显优势,LCT有较高的诊断灵敏度、特异度及标本满意度,结合阴道镜下活检及病理学检查可显著提高宫颈癌和癌前病变诊断的准确性。
[关键词] 宫颈肿瘤;癌前状态;细胞学技术
[ABSTRACT]ObjectiveTo evaluate the accuracy of liquid-based technologies (LCT) for screening cervical carcinoma and precancerous change. MethodsFrom January 2003 to January 2005, 14 533 cases were screened for cervical carcinoma and pre-cancerous change with LCT or traditional cervical- cell smears . TBS-group system was adopted for cytologic diagnosis. A positive diagnosis, which included unsatisfied samples and cases with atypical squamous cell of under mined significance (ASCUS) and a-bove, was examined with a colposcope. ResultsASCUS of LCT was significantly fewer than classical cervical smears ( χ2 = ,P <). The positive rates of cervical precancerous lesion of LCT were higher than classical s