Liquid-Based Cervical Cytology for Cervical Cancer Screening: A Retrospective Analysis of 61610 Cases

Objective To evaluate the value of liquid-based cytological test(LCT) as a screening method to detect cervical carcinoma.Methods The clinical data of 61 610 cases were collected from March 2004 to March 2011.The LCT results and colposcopic biopsy of 61 610 cases and 128 554 conventional Papnicoulau smears(CP) were compared and retrospectively analyzed.Follow-up diagnoses of colposcopic biopsy were available for those previously detected cytological abnormalities.Results ① Among 61 610 LCT results,1772(2.88%) cases were cytological interpreted as atypical squamous cell of undetermined significance(ASCUS) or above,and among them,1017 cases who received colposcopic biopsy showed 38 (0.06%,38/61 610) were squamous cell carcinoma(SCC) or cervical adenocarcinoma(GLCA),251(0.41%,284/61 610) were high grade squamous intraepithelial lesions(HSIL) [cervical intraepithelial neoplasia(CIN) Ⅱ,Ⅲ were 169 cases and 82 cases,respectively],409(0.66%,399/61 610) were low grade squamous intraepithelial lesions(LSIL)(216 were condyloma and 193 were CIN I),atypical glandular cell(AGC) were 5 cases,adenocarcinomain situ(AIS) were 2 cases,and chronic inflammation were 312 cases.In the results of 128 554 specimen by CP,272 cases(0.21%) were cytological interpreted as Pap Ⅲ or above.Among these 272 cases,253 who received biopsy showed that 65 cases were cytological interpreted as SCC or GLCA,97 were HSIL including 57 for CINⅡ and 40 for CINⅢ,82 were LSIL including 45 for CINⅠ and 37 for condyloma,9 were chronic inflammation.There was no significant difference between CP and LCT in detecting cervical carcinoma.② The consistent rate of LCT and histological diagnosis was the follow: HSIL(82.77%,173/209)SCC(73.53%,25/34)LSIL(63.46%,264/416).Conclusions Compared with CP,LCT has more sensitivity and reliability in screening for cervical carcinoma and SIL,especially in detecting HSIL.But we must pay more attention to the misdiagnosis or under-diagnosis of cervical carcinoma because of scant cellular,cell overlying,inflammation,etc.in the preparations.