国际妇产科学杂志

国际妇产科学杂志 ›› 2010, Vol. 37 ›› Issue (4): 288-290.

• 论著 • 上一篇    下一篇

改良取样巴氏涂片在人群子宫颈癌筛查中的应用

王国萍，李瑞珍，乌兰娜，李 鹃，刘志红，王 纯，何 芳，周艳秋，翁雷明，吴瑞芳   

  1. 518036 深圳，北京大学深圳医院宫颈癌早诊早治中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-08-15 发布日期:2010-08-15
  • 通讯作者: 吴瑞芳

Use the Conventional Papanicolaou Smear by Improved Take-samples in Screening Cervical Carcinoma in People

WANG Guo-ping，LI Rui-zhen，WU Lan-na，LI Juan，LIU Zhi-hong，WANG Chun，HE Fang，ZHOU Yan- qiu，WENG Lei-ming，WU Rui-fang   

  1. Centre of Early Diagnosis and Early Treatment for Cervical Carcinoma，Peking University Shenzhen Hospital， Shenzhen 518036，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-08-15 Online:2010-08-15
  • Contact: WU Rui-fang

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摘要： 目的：探讨改良取样巴氏涂片（Pap）在子宫颈癌筛查中的应用价值。方法：对500例30~59岁、3年内未行宫颈癌筛查的妇女行改良Pap、液基细胞学（LCT）和第二代杂交捕获实验（HC-Ⅱ）人乳头瘤病毒（HPV）检测，Pap采用液基细胞学刷取样，2种细胞学取样采用分配样本法。细胞学以无明确诊断意义不典型鳞状细胞（ASCUS）为阳性阈值，对任一细胞学结果或HPV检测阳性的妇女行阴道镜下宫颈多点活检，以病理诊断为金标准，评价2种细胞学方法筛查宫颈癌的价值。结果：宫颈细胞学筛查宫颈上皮内瘤样病变（CIN）Ⅱ以上病变以ASCUS为阳性阈值的筛查效率最高；改良Pap和LCT的筛查效率（ROC曲线下面积比较，Z ＝0.70，P ＞0.05）和不满意率（χ2＝0.343，P =0.558）差异无统计学意义；两种细胞学的诊断完全一致率为86.8%，宫颈癌和宫颈癌前病变级别越高，2种细胞学方法判读结果的一致性越好。结论：改良Pap经济有效，可广泛应用于人群子宫颈癌筛查。

关键词: 宫颈肿瘤, 阴道涂片, 染色与标记, 普查, 细胞学

Abstract: Objective：To investigate the value of conventional Papanicolaou smear （Pap） improved by take-samples in screening cervical carcinoma. Methods： Conventional Pap smear by improved take-samples, liquid-based cytology test, hybrid capture Ⅱ human papillomavarus test were performed in 500 women of 30-59 years old without screening cervical cancer in 3 years in Shang Mei-lin community of Shenzhen Futian region from December 2007 to March 2008. We obtained samples of Pap by a broom-type sampling device（take-samples used for LCT） with split-sampling method. The positive threhold of cervical cytology was atypical squamous cells of undetermined sign（ASCUS）. The women with either testing result of Pap，LCT or HPV positive received multi-spot biopsy under colposcopy. The pathology results were the final diagnosis criteria to evaluate the value of two cervical cytology for screening cervical cancer. Results：The best screening cervical intraepithelial neoplasia （CIN）Ⅱ threhold of cervical cytology was ASCUS；There were no significant differences of screening effectiveness and unsatisfactory rate between Pap with improved take-samples and LCT; The complete concordance of diagnosis between Pap and LCT was 86.8%，The higher grade cervical lesion，the better concordance of diagnosis between Pap and LCT. Conclusions：Pap smear with improved take-samples is economic and effective and is worth popularizing in screening cervical carcinoma.

Key words: Uterine cervical neoplasms, Vaginal smears, Staining and labeling, Mass screening, Cytology