本文關鍵詞： 細胞塊 宮頸液基細胞學 組織學陽性符合率 p　出處：《臨床與實驗病理學雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的探討細胞塊(cell block,CB)在宮頸液基細胞學(liquid-based preparation,LBP)中的應用價值。方法選擇LBP陽性標本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,同時制作成CB并行陰道鏡活檢247例,最終均以組織學診斷為金標準。結(jié)果對于非典型鱗狀上皮細胞(atypical squamous cells,ASC),應用LBP與LBP+CB檢測同時陽性的組織學陽性符合率差異有顯著性(72.3%±2.3%vs 83.2%±1.1%,P0.01),其中診斷為非典型鱗狀上皮細胞-意義不明的(atypical squamous cells of undetermined significance,ASC-US)標本中,LBP與LBP+CB同時陽性的組織學陽性符合率分別為66.28%(57/86)、78.85%(41/52);診斷為非典型鱗狀上皮細胞-不除外高級別鱗狀上皮內(nèi)病變(atypical squamous cells,cannot exclude hsil,ASC-H)標本中,LBP與LBP+CB同時陽性的組織學陽性符合率分別為82.98%(39/47)、89.74%(35/39)。對于低級別鱗狀上皮內(nèi)病變(low-grade squamous intraepithelial lesion,LSIL),LBP+CB同時陽性的組織學陽性符合率比LBP高,但差異無統(tǒng)計學意義(P0.05);而對≥高級別鱗狀上皮內(nèi)病變(high-grade squamous intraepithelial lesion,HSIL)和非典型腺細胞(atypical glandular cells,AGC),LBP與LBP+CB同時陽性的組織學陽性符合率一致;在62例LBP診斷LSIL標本中,CB診斷分別為無上皮內(nèi)病變或惡性病變(negative for squamous intraepithelial lesions or malignancy,NILM)2例、ASC-US 7例、ASC-H 10例、LSIL 33例、HSIL 10例;對于50例LBP診斷HSIL標本中,CB診斷分別為ASC-US 2例、ASC-H 11例、LSIL 5例、HSIL 30例、鱗狀細胞癌(squamous cell carcinoma,SCC)2例。HSIL、NILM、LSIL組中p16表達差異有顯著性(P0.05)。另外,p16在HSIL組中的陽性表達明顯高于LSIL組。結(jié)論 CB在LBP中的應用,可以提高宮頸癌篩查的組織學陽性符合率,也可作為臨床高度懷疑有病變或高危HPV而LBP未見陽性的一種補充,值得在臨床細胞病理學中推廣。
[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% 鹵2.3 vs 83.2% 鹵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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