HR―HPVTCT联合电子阴道镜下宫颈活检在宫颈癌前病变及宫颈癌诊断中应用.docVIP

HR―HPVTCT联合电子阴道镜下宫颈活检在宫颈癌前病变及宫颈癌诊断中应用 　　[摘要] 目的 探讨HR-HPV、TCT联合电子阴道镜下宫颈活检在宫颈癌前病变及宫颈癌诊断中的应用价值。方法 整群选取2015年1―10月该院收治的411例TCT阳性患者为研究对象，全部患者均行HR-HPV、TCT联合电子阴道镜下宫颈活检，对比不同诊断方法下宫颈癌前病变及宫颈癌的检出情况。 结果 HR-HPV、TCT联合阴道镜活检诊断宫颈病变的诊断率为73.5%，诊断ASCUS、CIN 1级、CIN 2级、CIN 3级的灵敏度分别为97.2%、96.3%、97.4%、100.0%，特异度分别为93.1%、61.0%、53.2%、57.2%，与单独HR-HPV或阴道镜活检比较差异均有统计学意义（P0.05）。结论 HR-HPV、TCT、电子阴道镜下宫颈活检的联合应用可显著提高宫颈癌前病变的检出率，对ASCUS及CIN的分流具有重要作用，能够为临床诊治宫颈癌提供有效依据，值得临床推广使用。 　　[关键词] HR-HPV检测；TCT；宫颈活检；宫颈癌；癌前病变 　　[中图分类号] R737 [文献标识码] A [文章编号] 1674-0742（2016）12（b）-0011-03 　　Application of HR-HPV， TCT and Cervical Biopsy in the Diagnosis of Cervical Precancerous Lesions and Cervical Cancer 　　HUA Quan，CHEN Jie，SHEN Yan 　　Nanjing Maternity and Child Care Center affiliated to Nanjing Medical University，Nanjing，Jiangsu Province，210004 China 　　[Abstract] Objective To explore the application value of HR-HPV， TCT combined with electronic cervical biopsy in the diagnosis of cervical precancerous lesions and cervical cancer. Methods Group selection January to October 2015 in our hospital 411 cases of TCT positive patients as the research object， all patients underwent HR-HPV and TCT combined with electronic colposcopy cervical biopsy. Results The diagnosis of HR-HPV and TCT combined with colposcopy biopsy in the diagnosis of cervical lesions was 73.5%， the diagnosis of ASCUS， CIN1 and CIN2 grade， CIN3 grade sensitivity were 97.2%， 96.3%， 97.4% and 100.0%， the specificity was 93.1%， 61%， 53.2% and 57.2%，the difference was statistics significant（P 0.05）. Conclusion HR-HPV， TCT， electronic colposcopy combined with cervical biopsy can improve the detection rate of cervical precancerous lesions， the ASCUS and CIN shunt plays an important role. 　　[Key words] TCT； HR-HPV testing； Cervical biopsy； Cervical cancer； Precancerous lesion 　　?m颈癌是女性常见恶性肿瘤，其发病率在妇科恶性肿瘤中仅次于乳腺癌，位居第2，严重威胁女性生命健康。宫颈癌早期无明显症状和体征，宫颈光滑或柱状上皮异位样，易误诊或漏诊。随着宫颈上皮内瘤变（CIN）进行性加重至原位癌、早期癌、浸润癌的出现，患者病症表现虽逐渐明显，但1年生存率也呈下降趋势。临床研究表明，CIN患者1年生存率可在95%以上，而浸润癌则不足70%[1]。由