细胞块在宫颈液基细胞学中的应用

发布时间：2018-01-19 05:05

  本文关键词： 细胞块 宫颈液基细胞学 组织学阳性符合率 p　出处：《临床与实验病理学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨细胞块(cell block,CB)在宫颈液基细胞学(liquid-based preparation,LBP)中的应用价值。方法选择LBP阳性标本285例,其中高危HPV 16型45例、HPV 18型58例,HPV高危其他型(31、33、35、39、45、51、52、56、58、59、66、68型)182例,同时制作成CB并行阴道镜活检247例,最终均以组织学诊断为金标准。结果对于非典型鳞状上皮细胞(atypical squamous cells,ASC),应用LBP与LBP+CB检测同时阳性的组织学阳性符合率差异有显著性(72.3%±2.3%vs 83.2%±1.1%,P0.01),其中诊断为非典型鳞状上皮细胞-意义不明的(atypical squamous cells of undetermined significance,ASC-US)标本中,LBP与LBP+CB同时阳性的组织学阳性符合率分别为66.28%(57/86)、78.85%(41/52);诊断为非典型鳞状上皮细胞-不除外高级别鳞状上皮内病变(atypical squamous cells,cannot exclude hsil,ASC-H)标本中,LBP与LBP+CB同时阳性的组织学阳性符合率分别为82.98%(39/47)、89.74%(35/39)。对于低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL),LBP+CB同时阳性的组织学阳性符合率比LBP高,但差异无统计学意义(P0.05);而对≥高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)和非典型腺细胞(atypical glandular cells,AGC),LBP与LBP+CB同时阳性的组织学阳性符合率一致;在62例LBP诊断LSIL标本中,CB诊断分别为无上皮内病变或恶性病变(negative for squamous intraepithelial lesions or malignancy,NILM)2例、ASC-US 7例、ASC-H 10例、LSIL 33例、HSIL 10例;对于50例LBP诊断HSIL标本中,CB诊断分别为ASC-US 2例、ASC-H 11例、LSIL 5例、HSIL 30例、鳞状细胞癌(squamous cell carcinoma,SCC)2例。HSIL、NILM、LSIL组中p16表达差异有显著性(P0.05)。另外,p16在HSIL组中的阳性表达明显高于LSIL组。结论 CB在LBP中的应用,可以提高宫颈癌筛查的组织学阳性符合率,也可作为临床高度怀疑有病变或高危HPV而LBP未见阳性的一种补充,值得在临床细胞病理学中推广。
[Abstract]:Objective to investigate liquid-based preparation in cervical liquid-based cytology. Methods 285 LBP positive specimens were selected, including 45 cases of high risk HPV 16 and 58 cases of HPV18. Two hundred and eighty-two patients were diagnosed as type 35-59, 51-51-51-52-56-58-56-668 type, and 247 cases were made CB and colposcopy biopsy at the same time, the results were as follows: (1) CB-assisted colposcopy biopsy was performed in 247 cases. The result was atypical squamous cells in atypical squamous epithelium. There was significant difference in the coincidence rate of histologic positive between LBP and LBP CB (72.3% 卤2.3 vs 83.2% 卤1.1 P 0.01). In which atypical squamous epithelial cells were diagnosed-with unknown significance (. Atypical squamous cells of undetermined significance. In ASC-US specimens, the histologically positive coincidence rates of LBP and LBP CB were 66.28% and 78.85%, respectively. Atypical squamous cells was diagnosed as atypical squamous epithelial-no exception for high-grade squamous intraepithelial lesions. The histologically positive coincidence rates of cannot exclude and LBP CB were 82.98 and 39 / 47, respectively. 89.74 / 35 / 39. Low-grade squamous intraepithelial lesion for low-grade squamous intraepithelial lesions. The histologically positive coincidence rate of LSILBP-CB was higher than that of LBP, but the difference was not statistically significant (P 0.05). But for high-grade squamous intraepithelial lesion of squamous intraepithelial lesions 鈮，

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