康旻

[摘要] 目的 探讨采用叶酸受体介导的宫颈特殊染色法（Flolate receptor mediated cervical special staining，FRD）上皮组织特殊染色液对宫颈病变检查的临床价值，为早期及时发现宫颈癌前病变及宫颈癌提供参考依据。 方法 选取2015年7月～2017年7月本院婦科门诊年龄常规进行宫颈癌筛查的20～60岁女性患者10 000例。分别行FRD宫颈特殊染色和液基细胞检查（Thinprep cytologic test，TCT），筛查出399例行阴道镜检查及病理活检，以病检为金标准，比较两者的诊断结果。 结果 以组织病理宫颈上皮内瘤变Ⅱ级（CINⅡ）及以上病变为阳性标准，TCT组、FRD组分别与病理检查结果比较，均无统计学差异（χ2=1.88，1.52，P=0.17，0.52）。FRD组阳性预测值、阴性预测值、灵敏度、特异度、误诊率、漏诊率与TCT组无统计学差异（χ2=2.384，P=0.794），但前者阳性活检率高于后者（χ2=12.25，P=0.00）。 结论 FRD宫颈特殊染色在宫颈癌前病变及宫颈癌筛查中较传统方法简便、经济、快速，可以作为一种新方法推广。

[关键词] 醋酸白溶液；宫颈上皮内瘤变；液基细胞学；宫颈活检

[中图分类号] R737.3 [文献标识码] A [文章编号] 1673-9701（2018）20-0001-04

Study on the application of white acetic acid solution in cervical intraepithelial neoplasia of grade Ⅱ and above

KANG Min

Department of Gynecology， Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine， Zhuhai 519000， China

[Abstract] Objective To investigate the clinical value of special staining fluid of epithelial tissue stained with Folate Receptor Mediated Cervical Special Staining（FRD） for the examination of cervical lesions， and to provide references for the early detection of cervical precancerous lesions and cervical cancer. Methods A total of 10 000 patients who were routinely screened for cervical cancer with the age of 20 to 60 in the gynecological outpatient of our hospital from July 2015 to July 2017 were selected. They were given FRD special cervical staining and TCT （Threprep cytologic test） respectively. 399 patients were screened for colposcopy and biopsy. The medical examination was taken as the gold standard， and the diagnostic results of the two were compared. Results The pathological changes of cervical intraepithelial neoplasia grade Ⅱ （CINⅡ） and above were taken as positive criteria. There was no statistically significant difference between the TCT group and the FRD group in pathological examination results（χ2=1.88， 1.52， P=0.17， 0.52）. There was no statistically significant difference between the FRD group and the TCT group in the positive predictive value， negative predictive value， sensitivity， specificity， misdiagnosis rate， and missed diagnosis rate（χ2=2.384， P=0.794）. However， the positive biopsy rate of the former was higher than that of the latter（χ2=12.25， P=0.00）. Conclusion FRD special cervical staining is simpler， more economical and rapid than traditional methods in cervical precancerous lesions and cervical cancer screening. It can be used as a new method for promotion.

[Key words] White acetic acid solution； Cervical intraepithelial neoplasia； Thinprep cytology； Cervical biopsy

宫颈癌是一种严重危害妇女健康的恶性肿瘤，发病率在女性恶性肿瘤中居第二位。中国是宫颈癌高发区之一，由于普查率尚不足5%及受HPV感染增加等影响，宫颈癌发病率增加且呈年轻化趋势。在我国农村地区医疗资源相对不足，TCT（Thinprep cytologic test）及HPV（Human papilloma virus）检查很难开展，因此使用一种简单有效的方法对减少宫颈癌发病率，降低死亡率有重要意义。FRD宫颈特殊染色属于新型的上皮诊断技术，具有操作简单、结果快速、费用低廉等优点。因此我院门诊开展FRD（Flolate receptor mediated cervical special staining）宫颈特殊染色检查和液基细胞检查，以阴道镜活检病理诊断为金标准，探讨FRD在宫颈癌筛查中的价值。……