HPV联合TCT检查在女性体检中意义.docVIP

HPV联合TCT检查在女性体检中意义 　　【摘 要】目的：探讨HPV-DAN检测联合TCT在女性筛查宫颈病变体检中的临床意义。方法：HPV-DNA的检测采用美国Digene公司推出的第二代杂交捕获（Hybrid CtureZ，HC-Ⅱ）试验，宫颈脱落细胞病变程度检测采用薄层细胞学检测系统（TCT），宫颈组织病理活检采用经典方法。结果：在受检者中，随着细胞诊断级别的升高，HPV的感染率亦随之上升，ASCUS、ASC-H、LSIL、HSIL的HPV感染率分别为41.30%、55.73%、80.42%、88.50%，TCT、HPV单项检出率分别为32.0%和38.4%，而两者联合检出率为49.2%；HPV和TCT均阳性的患者中，CINⅢ及以上的病变检出率最高，HPV和TCT均阴性的患者中，无一例CINⅢ及以上的病变，P0.01，差异有统计学意义。结论：TCT和HPV-DNA联合检测可提高宫颈病变的诊出率，两者互补，降低单一检查所造成的假阴性率，从而更利于体检时早期发现宫颈病变，积极治疗并防止恶变。 　　【关键词】 HPV；宫颈癌；TCT；病理活检 　　The Clinical Significance of HPV Combine TCT in the Physical Examination of Female 　　[Abstracts] Objective： To investigate the clinical significance of HPV-DAN combine TCT in the screening of cervical lesions of women. Methods： HPV-DNA was detected by he second generation Hybrid Capture （Hybrid CtureZ， HC-Ⅱ） test launched by Digene in the United States ， cervical cell lesions was detected by thin-layer cytology system （TCT）， cervical tissue biopsy using the classical methods. Results： In all the subjects， along with elevated levels of cell diagnosis， the rates of HPV infection also rise， respectively were 41.30%， 55.73%， 80.42%， 88.50% in the group of ASCUS， ASC-H， LSIL and HSIL， the individual detection rates of TCT and HPV were 32.0% and 38.4%， while the combination of the two was 49.2%； the patients which HPV and TCT were both positive have the highest detection rate of CINⅢ and ， no case was CINⅢ and higher level in the patients which HPV and TCT were both negative， P0.01， the difference has statistically significant. Conclusion： TCT and HPV-DNA detection can be combined to improve the rate of diagnosis of cervical lesions， they complement each other， reducing the false negative rate caused by single check， and thus more conducive to discover the cervical lesions in their physical examination， to take active treatment and to prevent malignant transformation. 　　[Key words] HPV； Cervical Cancer； TCT； Biopsy 　　宫颈癌是指发生在宫颈阴道部或移行带的鳞-柱交界处的恶性肿瘤，它不仅是女性生殖器官癌瘤中最常见的一种，也是女性各种恶性肿瘤中最多见的一种。现已证实[1]，宫颈