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[罗兹市ICZMP运营妇科部开展的宫颈癌深入诊断项目中宫颈标本巴氏涂片异常情况与组织病理学检查结果的对比分析]

[Comparative analysis of abnormal Pap smear and the results of histopathological examination of specimens from the cervix of the programme in-depth diagnosis cervical cancer conducted at the of Operational Gynecology Department ICZMP in Lodz].

作者信息

Kulig Bartosz, Łukaszek Stanisław, Brucka Aleksandra, Kałuzyński Andrzej, Kamer-Bartosińska Anna, Szyłło Krzysztof

机构信息

Klinika Ginekologii Operacyjnej Instytut Centrum Zdrowia Matki Polki w Łodzi.

出版信息

Ginekol Pol. 2010 Nov;81(11):828-33.

Abstract

INTRODUCTION

Cervical Cancer Screening Program has been operational in Poland for over four years. Colposcopy and guided biopsy methods constitute an essential part of population-based screening, enable stating right diagnosis and planning treatment procedures.

AIM

The aim of the following study was to analyse the diagnostic acuity of cyto- and histopathological examination.

RESULTS

We examined 510 patients with the following result of cytological smear: ASCUS--265 women (51.96%), LSIL--167 cases (35.75%), HSIL--78 women (15.29%). Complete agreement between cytological smear and guided biopsy histopathology was observed among 81.13% cases of ASCUS, in 88.02% of women with LSIL and in 76.92% cases with the diagnosis of HSIL. As with cytology-biopsy comparisons, discordant cases were significantly more frequent in the group with stated HSIL than among patients with the diagnosis of ASCUS or LSIL (p<0.001).

CONCLUSIONS

  1. High cyto-histopathological accordance (82%) has been obtained, what is comparable with the data in literature. 2. The highest cyto- histopathological compatibility was obtained in the group of patients with LSIL--over 88%, and the lowest in the group of patients with HSIL--less than 77%. 3. Failure to confirm the histopathological diagnosis of cytological HSIL requires further molecular and morphological evaluation.
摘要

引言

宫颈癌筛查项目在波兰已实施四年多。阴道镜检查和引导活检方法是基于人群筛查的重要组成部分,有助于做出正确诊断并规划治疗程序。

目的

以下研究的目的是分析细胞学和组织病理学检查的诊断准确性。

结果

我们检查了510例患者,其细胞学涂片结果如下:非典型鳞状细胞不能明确意义(ASCUS)——265名女性(51.96%),低度鳞状上皮内病变(LSIL)——167例(35.75%),高度鳞状上皮内病变(HSIL)——78名女性(15.29%)。在ASCUS病例中,81.13%的病例细胞学涂片与引导活检组织病理学完全一致;在LSIL女性患者中,这一比例为88.02%;在诊断为HSIL的病例中,这一比例为76.92%。与细胞学-活检比较一样,诊断为HSIL的组中不一致病例比诊断为ASCUS或LSIL的患者组明显更频繁(p<0.001)。

结论

  1. 已获得较高的细胞-组织病理学符合率(82%),与文献数据相当。2. LSIL患者组获得了最高的细胞-组织病理学兼容性——超过88%,而HSIL患者组最低——不到77%。3. 未能证实细胞学HSIL的组织病理学诊断需要进一步的分子和形态学评估。

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