TBS系统的判读

1、（、）、）、）、）、）、）同时强调宫颈细胞学诊断分类和术语同时强调宫颈细胞学诊断分类和术语同时强调宫颈细胞学诊断分类和术语同时强调宫颈细胞学诊断分类和术语同时强调宫颈细胞学诊断分类和术语同时强调宫颈细胞学诊断分类和术语应与应与应与应与应与应与组织组织组织组织组织组织学分类和术语相一致，以反映病变的性质。学分类和术语相一致，以反映病变的性质。学分类和术语相一致，以反映病变的性质。学分类和术语相一致，以反映病变的性质。学分类和术语相一致，以反映病变的性质。学分类和术语相一致，以反映病变的性质。 鳞状上皮鳞状上皮鳞状上皮 NILMNILMNILMNILMNILMNILMNILMNILMNILMNIL

2、M NILM NILM （炎症）（炎症）（炎症）（炎症）（炎症）（炎症）NILM NILM NILM （纤毛菌）（纤毛菌）（纤毛菌）（纤毛菌）（纤毛菌）（纤毛菌）NILM NILM NILM （滴虫）（滴虫）（滴虫）（滴虫）（滴虫）（滴虫）NILM NILM NILM （念珠菌）（念珠菌）（念珠菌）（念珠菌）（念珠菌）（念珠菌）非典型鳞状细胞：非典型鳞状细胞：非典型鳞状细胞：非典型鳞状细胞：非典型鳞状细胞：非典型鳞状细胞：ASCUS:ASCUS:ASCUS:意义不明确的非典型性磷状细胞（意义不明确的非典型性磷状细胞（意义不明确的非典型性磷状细胞（意义不明确的非典型性磷状细胞（意义不明确的非典型

3、性磷状细胞（意义不明确的非典型性磷状细胞（atypicalatypicalatypical squamous squamous squamous cells of undetermined cells of undetermined cells of undetermined significance significance significance）ASCH:ASCH:ASCH:非典型性磷状细胞，不除外高级别磷状上皮内非典型性磷状细胞，不除外高级别磷状上皮内非典型性磷状细胞，不除外高级别磷状上皮内非典型性磷状细胞，不除外高级别磷状上皮内非典型性磷状细胞，不除外高级别磷状上皮内非典型性磷状细

4、胞，不除外高级别磷状上皮内 病变（病变（病变（病变（病变（病变（atypical squamous cells,cannotatypical squamous cells,cannotatypical squamous cells,cannot exclude high-grade squamous exclude high-grade squamous exclude high-grade squamous intraepithelial lesion intraepithelial lesion intraepithelial lesion）2 2 2）鳞状细胞异常）鳞状细胞异常）鳞状细胞

5、异常）鳞状细胞异常）鳞状细胞异常）鳞状细胞异常: : :非典型鳞状细胞：非典型鳞状细胞：非典型鳞状细胞：非典型鳞状细胞：非典型鳞状细胞：非典型鳞状细胞：ASCUS:ASCUS:ASCUS:意义不明确的非典型性磷状细胞意义不明确的非典型性磷状细胞意义不明确的非典型性磷状细胞意义不明确的非典型性磷状细胞意义不明确的非典型性磷状细胞意义不明确的非典型性磷状细胞 （atypical squamousatypical squamousatypical squamous cells of cells of cells of undetermined significance undetermined si

6、gnificance undetermined significance）ASCH:ASCH:ASCH:非典型性磷状细胞，不除外高级别磷状上非典型性磷状细胞，不除外高级别磷状上非典型性磷状细胞，不除外高级别磷状上非典型性磷状细胞，不除外高级别磷状上非典型性磷状细胞，不除外高级别磷状上非典型性磷状细胞，不除外高级别磷状上皮内病变（皮内病变（皮内病变（皮内病变（皮内病变（皮内病变（atypical squamous cells,cannotatypical squamous cells,cannotatypical squamous cells,cannot exclude high-grade

7、squamous exclude high-grade squamous exclude high-grade squamous intraepithelial lesion intraepithelial lesion intraepithelial lesion）2 2 2）鳞状细胞异常）鳞状细胞异常）鳞状细胞异常）鳞状细胞异常）鳞状细胞异常）鳞状细胞异常: : : ASC-H :ASC-H :ASC-H : Cytologic features of enlarged nuclei and reduced Cytologic features of enlarged nuclei and

8、 reduced Cytologic features of enlarged nuclei and reduced cytoplasm resulting in a marked increase in the cytoplasm resulting in a marked increase in the cytoplasm resulting in a marked increase in the nuclear/cytoplasmicnuclear/cytoplasmicnuclear/cytoplasmic ratio, characteristic of a high-grade r

9、atio, characteristic of a high-grade ratio, characteristic of a high-grade intraepithelial lesion . intraepithelial lesion . intraepithelial lesion . SQUAMOUS CANCER:SQUAMOUS CANCER:SQUAMOUS CANCER: Very enlarged nuclei with irregular Very enlarged nuclei with irregular Very enlarged nuclei with irr

10、egular distribution of nuclear material and nucleoli (red clumps in distribution of nuclear material and nucleoli (red clumps in distribution of nuclear material and nucleoli (red clumps in nuclei); dense spindled pink/orange cytoplasmnuclei); dense spindled pink/orange cytoplasmnuclei); dense spind

11、led pink/orange cytoplasm. . .(HPV)(HPV)(HPV)(EBV)(EBV)(EBV)(HBV)(HBV)(HBV) human human human papillomapapillomapapilloma- - -virus (virus (virus (HPVHPVHPV)- )- )-nuclear atypia nuclear atypia nuclear atypia and and and perinuclear perinuclear perinuclear cytoplasmiccytoplasmiccytoplasmic cavitatio

12、ncavitationcavitation or or or “halo,” . HPV “halo,” . HPV “halo,” . HPV infection ofinfection ofinfection of low-grade low-grade low-grade squamoussquamoussquamous intraepithelial intraepithelial intraepithelial lesion (LSIL). lesion (LSIL). lesion (LSIL). The nucleus is larger than the nucleus of a n