宫颈薄层液基细胞学检测联合高危型人乳头状瘤病毒检测对筛查宫颈鳞状上皮内瘤变应用价值分析.docVIP

宫颈薄层液基细胞学检测联合高危型人乳头状瘤病毒检测对筛查宫颈鳞状上皮内瘤变应用价值分析 　　【摘要】目的：分析宫颈薄层液基细胞学（TCT）联合高危型人乳头状瘤病毒（高危型HPV）检测对筛查宫颈鳞状上皮内瘤变的应用价值。方法：2014年1月至12月选取2400例自愿接受宫颈病变筛查的妇女，均行TCT筛查。对218例TCT检查结果阳性者（ASCUS及以上）进一步行高危型HPV检测及阴道镜下宫颈活检病理检查。 结果：在218例TCT检查结果阳性者中，TCT结果与病理学结果符合率分别为鳞状上皮低度病变（LSIL）60%，非典型鳞状细胞-不除外上皮内高度病变（ASC-H）846%，鳞状上皮高度病变（HSIL）100%。高危型HPV在不同程度的宫颈癌前病变中占的比例分别为CINⅠ 878%、CINⅡ 916%、CINⅢ 933%，高危型HPV的感染率随着宫颈病变的严重程度增加而明显升高。TCT检查及高危型HPV检测阳性与病理学符合率为659%。结论：TCT联合高危型HPV检测提高了宫颈鳞状上皮内瘤变筛查的特异性及敏感性，具有良好的临床应用价值。 　　【关键词】薄层液基细胞学；乳头状瘤病毒；宫颈鳞状上皮内瘤变 　　Application of TCT joint high-risk type HPV testing for screening cervical squamous intraepithelial neoplasiaHUANG Xing， YANG Li， GUO Hua， XU Yan. Department of Obstetrics and Gynecology， Panyu Center Hospital， Guangzhou 511400， China 　　【Abstract】Objectives： To analyze the application value of ThinPrep cytology （TCT） in combination with high-risk type HPV testing for screening cervical intraepithelial neoplasia （CIN）. Methods： 2400 women willing to receive cervical disease screening from January to December 2014 were selected for TCT screening. 218 women with positive screening results （ASCUS and above） were further given high risk HPV testing and colposcopy and biopsy. Results： Of the 218 women， the cytological and pathological diagnosis coincidence rate of LSIL， ASC-H and HSIL was 60%， 84.6% and 100%. The positive rate of high-risk type HPV in different colposcopy and biopsy lesions were CINⅠ of 878%， CINⅡ of 91.6% and CINⅢ of 93.3%. The positive rate of high risk type HPV increased significantly with the aggravating degree of colposcopy and biopsy lesions. The consistency was 65.9% for pathology vs. HPV assay plus TCT positive. Conclusion： TCT combined with high-risk type HPV testing， increases the sensitivity and specificity of the diagnosis of cervical lesions， having good clinical application value. 　　【Key words】ThinPrep cytology （TCT）； Papillomavirus； Cervical intraepithelial neoplasia 　　【中图分类号】R167【文献标志码】A 　　宫颈癌是女性生殖系统最常见的恶性肿瘤，是目前惟一明确病因的妇科恶性肿瘤，持续高危型人乳头