宫颈细胞刷取材：传统涂片及液基涂片比较分析.docVIP

宫颈细胞刷取材：传统涂片及液基涂片比较分析 　 作者：谭学君，黄光炜，叶丽群 【摘要】 目的 改进传统宫颈细胞学的取材方式，用宫颈细胞刷取材，比较传统涂片与液基涂片在宫颈癌筛查中阳性细胞检出率的差异。方法 用上述两种方法进行宫颈癌筛查，TBS系统诊断报告。细胞阳性的病人行阴道镜下病理活检。SPSS软件包分析结果。结果 两种不同的制片方法细胞学阳性率未明确诊断意义的非典型鳞状上皮细胞（ASC-US及以上）为：传统涂片6.26%（63/1007），液基涂片6.98%（75/1075），两种制片方法对宫颈癌筛查中阳性细胞的检出率差异无显著性。细胞学阳性者与病理活检诊断结果符合率均较高（Plt;0.05）。结论 液基细胞学的问世，只是制片技术的重大革新，但不能完全替代人工的经验判读且成本低的传统涂片方法。 【关键词】 宫颈细胞刷；宫颈疾病/诊断；阴道涂片；液基涂片 Abstract: Objective To improve the collection devices for obtaining cervical samples. The positive rates of detection for cervical cancer screening were compared between conventional smears and liquid-based smears. Methods The mentioned above devices were used for cervical cancer screening in 2082 women in Dongguan Hospital of Traditional Chinese Medicine from Jan. 2006 to Apr. 2007 and the TBS diagnosis system was used to report the laboratory results. The colposcopy following the abnormality of smears. SPSS software was used to analyze the record data. Results The positive rates of the two different preparation smears both with cytobrush for ASC-US were: 6.26% (63/1007) of conventional smears, 6.98% (75/1075) of liquid-based smears. In comparison of the positive rate for cervical cancer between this two preparation devices, there were no statistically significant differences. The coincident rate between the result of patients with abnormal cytology and that of pathological diagnosis was high (Plt;0.05). Conclusion The liquid-based cytology is an innovation for preparation technique, but it can not completely replace human experience reading as well as low-cost traditional smears technique. Key words: cytobrush; cervix disease/diagnosis; vaginal smears; liquid-based smears 　　液基细胞学检查被公认是细胞学领域的重大进步，能大大提高细胞学诊断的准确性，但因其价格昂贵、成本较高而影响了其在经济不发达地区、低收入人群中进行宫颈癌的筛查。传统的巴氏涂片，在过去的50年里因简单、方便、成本低廉对妇女宫颈癌的普查做出过巨大的贡献，但近年来由于其取材方式和制片技术而导致的假阴性和假阳性率较高也受到批评。笔者把液基细胞学的取材方式应用于传统的涂片技术中，摒弃了传统的取材工具：棉签、刮板等，规范宫颈细胞学的取材操作方式，直接涂片制片，与液基细胞学制片相比较。现将结果报告如下。 　　1 对象和方法 　　1.1 对象 　　2006年1月～2007年4月东莞市中医院病理科同时运用改良的传统宫颈涂片和液基细胞学涂片方法（