Applied Value Of ThinPrep Cytology Test In Cervical Carcinoma And Precancerosis

Objective:Under normal circumstance, have multiple defense functions, including mucosa immunity,humoral immunity and cell immunity, which are important lines of defens of supra-gential tract to prevent pathogenic bacterium.But cervix also suffer damage from accouchement , coition and various kinds of metra-cavea manipulation,then,simple columnar epithelium of cervical canals have very poor capability of anti-infection,which is easy to take place to be infected and to cause cervicitis.Cervical intraepithelial neoplasia (CIN) are a lot of lesion precancerous which are together with to invasive carcinoma of cervix.CIN reflect continuous process of development of cervical cancer.CIN have two different end-results:one is spontaneous regression,which seldom grow to infiltrating carcinoma;another one is the potency of canceration, maybe infiltrating carcinoma. Cervical cancer is the most common malignant tumour in gynecology,which attack rate and case fatality are in the first place .But along with the uninterrupted development of TRT technique, early discovery and treatment of cervical cancer and lesion precancerous make the disease incidence and death rate decrease obviously.IN 1998, the United States of America thrusted out diagnose report of cervix cell pathology (the bethsda system ,TBS).Seminardeterminatly improved the TBS in 2001,including forty-two academic societies from different nation.Our country initiated to introduce this report(TBS 2001) from 1990 .The report has gradually take the place of the pastometer grouping to go through considerable practice application.For the past few years,the application of liquid based cytology technique {TCT} have more subtily ,more precisly and more conveniently detected cervix affection. There were considerable literature reports about the diagnostic value of cervix cancer and precancerosis in clinic.This investigation intend to approach applied value of ThinPrep Cytology Test in cervical carcinoma and precancerosis,and look forward to providing more subtile,more precise and more convenient approach for clinical examination of cervical carcinoma and precancerosis.Methods: This investigation choose 612 women as research object ,who visited department of gynaecology and obstetrics out-patient clinic in The second affiliated hospital of Dalian Medical University from 2007.4 to 2008.1.These women all have vita sexualis,and did not have operation on cervix and hysterectomia. To compare with the disposition of few affection category in different age grades.Cytologic diagnosis deploy TBS class system.Make unrepresentative squamous cell(ASC-US) and above affection as masculine affection.Gold standard is histodiagnosis. Then make cervical biopsy masculine affection by means of gold standard.Record sensitivity ,specificity ,rate of missed diagnosis, misdiagnosis rate,concordance indicatrix(Kappa and coincidence) and predictive value(positive and negative predictive value).Usingχ2 analysis to compare with the difference between diagnose result with pathology .Results:1.TCT examination result report:in 612 case,postive case is one hundred and forty-four; AGUS is sevnty-four,LSIL is fifty-two,HSIL is twenty-four,SCC+AC is four。2.TCT examination result analysis: TCT validity estimate index: sensitivity is 98.05 % , specificity is99.35 %, rate of missed diagnosis is1.95% , misdiagnosis rate is 1.06 %;concordance indicatrix: coincidence is 93.5 % , accuracy is 98.7% ; positive predictive value is 74.15 % ,and negative predictive value is 98. 72 %.3.Positive coincidence between TCT result and pathology:According to TBS class system,estimate positive coincidence between TCT result and pathology:AGUS is sevnty-two,LSIL is fifty-one,HSIL is twenty-four,SCC+AC is four.AGUS,LSIL and HSIL have statistical significance.4.Age stage:CIN major distribute from thirty-one years-old to fifty years-old;the age stage has no obvious difference.