河北省10 111例宫颈薄层液基细胞学检查结果及诊断分析
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摘要
目的分析河北省人民医院就诊10 111例妇女宫颈薄层液基细胞学(thinprep cytologic test,TCT)结果,观察宫颈病变发生情况及分布特点。方法回顾性分析2016年12月5日—2018年2月5日在河北省人民医院妇科门诊就诊的10 111例患者TCT检验结果,比对诊断为宫颈上皮不典型鳞状上皮细胞(atypical squamous cells of undetermined signification,ASC-US)及以上患者的细胞病理学(TCT)结果和组织病理学(阴道镜组织活检)结果,并进行统计学分析。结果 10 111例患者中,910例TCT结果呈阳性,占9.00%。31～50岁所占比例最高(53.74%)。21～30、>60岁两个年龄组细胞学阳性各级别之间差异有统计学意义(P <内病变(low grade squamous intraepithelial lesion,LSIL)与高度鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)三组病例的平均年龄两两比较差异均有统计学意义(P<0.05),且HSIL病例的平均年龄明显高于LSIL病例(P<0.05)。TCT检查阳性病例中,139例进行了病理组织活检,活检阳性病例为105例,细胞学阳性结果与组织病理学阳性诊断结果符合率为75.54%。病原体微生物检查中,以线索细胞感染为主。结论宫颈液基细胞学检查对宫颈病变筛查有重要作用,宫颈病变发生及分布情况可为后期相关的研究做基础。
Objective To analyze the results of thinprep cytologic test(TCT) in 10 111 cervical women in outpatient clinic in Hebei. The occurrence and distribution of cervical lesions were observed. Methods Retrospective analysis was conducted on the data of 10 111 cases accepting TCT in Hebei General Hospital from December 5, 2016 to February 5, 2018,and the results were analyzed. The results of cytopathology and histopathology of the patients diagnosed as atypical squamous epithelial cells of the cervix(ASC-US) and above were statistically analyzed. Results The results of TCT showed that 910 patients were positive, accounting for 9.00%. Among all patients with positive cytology, the highest proportion was 31-50 years(53.74%). There was a statistically significant difference in the positive levels of cytology between the ages of 21 to 30 and >60 years old(P<0.05). The average age of each of the two groups were compared statistically significant in ASC, LSIL and HSIL groups(P<0.05). The average age of HSIL cases was significantly higher than that of LSIL cases(P<0.05). Of the positive cases of TCT examination, 139 cases underwent pathological biopsy, and 105 cases were positive for biopsy. The coincidence rate of positive cytology and histopathological diagnosis was 75.54%. In the pathogen microbiological examination, clue cells was the main factor. Conclusion Cervical cytological examination plays an important role in the screening of cervical lesions. The occurrence and distribution of cervical lesions can be the basis for later related studies.
Objective To analyze the results of thinprep cytologic test(TCT) in 10 111 cervical women in outpatient clinic in Hebei. The occurrence and distribution of cervical lesions were observed. Methods Retrospective analysis was conducted on the data of 10 111 cases accepting TCT in Hebei General Hospital from December 5, 2016 to February 5, 2018,and the results were analyzed. The results of cytopathology and histopathology of the patients diagnosed as atypical squamous epithelial cells of the cervix(ASC-US) and above were statistically analyzed. Results The results of TCT showed that 910 patients were positive, accounting for 9.00%. Among all patients with positive cytology, the highest proportion was 31-50 years(53.74%). There was a statistically significant difference in the positive levels of cytology between the ages of 21 to 30 and >60 years old(P<0.05). The average age of each of the two groups were compared statistically significant in ASC, LSIL and HSIL groups(P<0.05). The average age of HSIL cases was significantly higher than that of LSIL cases(P<0.05). Of the positive cases of TCT examination, 139 cases underwent pathological biopsy, and 105 cases were positive for biopsy. The coincidence rate of positive cytology and histopathological diagnosis was 75.54%. In the pathogen microbiological examination, clue cells was the main factor. Conclusion Cervical cytological examination plays an important role in the screening of cervical lesions. The occurrence and distribution of cervical lesions can be the basis for later related studies.
引文
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[11]郑宝文,梁小曼,陈从德.广东省农村妇女宫颈癌筛查99 573例宫颈液基细胞学标本TBS筛查结果分析[J].广东医学, 2018, 39(8):1205-1208.
[12]宋艳波,王少明,董丹,等.内蒙古地区液基细胞学与人乳头瘤病毒分型检测筛查宫颈癌的对比研究[J].中国妇产科临床杂志,2016, 17(1):10-13.
[13]吕京澴,宋芳,许伟伟,等.24687例宫颈液基薄层细胞学检查结果分析[J].中国实用医药,2013,8(26):10-11.
[14]吴绪峰.宫颈病变的诊断与治疗[M].武汉:湖北科学技术出版社,2010:45-46.
[15] American College of Obstetricians and Gynecologist. ACOG prac?tice bulletin No. 157[J]. Obstet Gynecol,2016,127:185-187.
[2]马丁.精准医疗在宫颈癌防治中的应用[J].实用妇产科杂志,2017,33(6):403-406.
[3]张文晶,刘志强.宫颈癌筛查方法及其应用现状[J].医学综述,2017,23(9):1732-1736.
[4]刘雯,于瑞梅,刘晓丹. 7857例育龄期妇女宫颈液基薄层细胞学检测结果分析[J].山东医药, 2017, 56(19):53-5.
[5]吴萍,王琳,张秋红,等.宫颈E6/E7mRNA联合TCT检查在一般妇女宫颈病变早期筛查中的应用[J].中华全科医学, 2018, 16(2):253-256.
[6]李红梅,姚彦生.11722例已婚女性宫颈液基细胞学筛查结果分析[J].中国妇幼保健, 2016, 31(14):2843-2845.
[7]张云清,韩慧慧,张冠军,等.宫颈薄层液基细胞学15000例检查结果及诊断分析[J].中国妇幼健康研究, 2017,28(8):1000-1002.
[8]石亚春,卓延峰.人乳头瘤病毒和宫颈液基细胞学检测在宫颈癌、癌前病变筛查中的应用[J].现代中西医学, 2018, 30(1):93-95.
[9]李琳.宫颈液基细胞学筛查7918例配合阴道镜检查结果分析[J].医药前沿,2013,3(12):232-233.
[10]刘湘红,曾萼,韦朋海.广西农村妇女宫颈癌及癌前病变筛查结果分析[J].中国热带医学, 2017, 17(11):1093-1097.
[11]郑宝文,梁小曼,陈从德.广东省农村妇女宫颈癌筛查99 573例宫颈液基细胞学标本TBS筛查结果分析[J].广东医学, 2018, 39(8):1205-1208.
[12]宋艳波,王少明,董丹,等.内蒙古地区液基细胞学与人乳头瘤病毒分型检测筛查宫颈癌的对比研究[J].中国妇产科临床杂志,2016, 17(1):10-13.
[13]吕京澴,宋芳,许伟伟,等.24687例宫颈液基薄层细胞学检查结果分析[J].中国实用医药,2013,8(26):10-11.
[14]吴绪峰.宫颈病变的诊断与治疗[M].武汉:湖北科学技术出版社,2010:45-46.
[15] American College of Obstetricians and Gynecologist. ACOG prac?tice bulletin No. 157[J]. Obstet Gynecol,2016,127:185-187.