Abstract:

Objective To assess the value of liquid-based thinlayer cytology test(TCT),colposcopy and biopsy in the diagnosis of cervical intraepithelial neoplasia and cervical cancer.Methods 6 201 outpatients in Department of Gynecology,Beijing(Chuiyangliu) Hospital,were given liquid thinlayer cytology examinations from June 2002 to February 2005, the positive cases of TCT were 442,with 324 TCT of negative results but suspected cervical lesions in clinical symptoms,both of 766 cases further underwent colposcopy and biopsy.Pathohistology was golden standard for the diagnoses of different methods.Results 442 cases were positive in 6 201 cases which were screened with TCT.The incidence was 7.13%,with TCT-diagnosed HSIL 21cases,LSIL 82 cases,CC 4 cases,ASCUS/AGUS 335 cases.Colposcopy and pathology diagnosed HSIL 34 cases and 36 cases,LSIL 143 cases and 153 cases,CC both 5 cases,inflammation 584 cases and 572 cases respectively.Compared with pathology,Kappa value of colposcopy checking ≥LSIL and ≥HSIL were 0.887 and 0.868,higher than Kappa value 0.615 and 0.716 of TCT checking ≥LSIL and ≥HSIL.The sensitivity of diagnosis≥LSIL with TCT and colposcopy were 53.1% and 88.7%(P<0.01) respectively,specificity were 99.3% and 98.3%(P>0.05) respectively,total consistent rate were 87.6% and 95.9%(P<(0.01)) respectively,omission diagnostic rate were 46.9% and 11.3%(P<0.01),negative predictive valve were 86.2% and(96.2)%(P<0.01),positive predictive valve were 96.3% and 94.5%(P>(0.05)),misdiagnosis rates were 0.7% and 1.7%((P>)0.05) respectively.Among the 335 cases with ASCUS/AGUS diagnosed with pathohistology,the 282 cases with inflammation,48 cases with CINⅠ,3 cases with CINⅡand 2 cases with CINⅢ.Conclusion Liquid-based thinlayer cytology test used for preliminary screening,can be combined with colposcopic examination and biopsies for clinical diagnosis.In this way,the detection rate and accuracy of cervical diseases can be improved.ASCUS/AGUS cases need more sophisticated examinations.

Key words: liquid-based thinlayer cytology, colposcopy, cervical intraepithelial neoplasia