宫颈癌筛查中HPV检测及TCT检查应用意义.docVIP

宫颈癌筛查中HPV检测及TCT检查应用意义 　　[摘要]目的 探讨宫颈癌筛查中高危型人乳头瘤病毒（HPV）检测及液基薄层细胞学检查（TCT）的应用意义。方法 选取2013年1月～2015年12月我院120例疑似宫颈癌患者作为研究对象，所有患者均接受HPV检测、TCT检查，以病理诊断结果作为“金标准”，计算HPV、TCT对宫颈癌的诊断敏感度、特异度、准确度，并比较两组的诊断结果。根据宫颈病变程度进行分组，比较宫颈上皮内瘤变（CIN）Ⅰ级、CINⅡ级、CINⅢ级，宫颈癌的HPV病毒载量。结果 HPV对宫颈癌的诊断敏感度、特异度、准确度分别为96.00%、73.33%、87.50%，TCT对宫颈癌的诊断敏感度、特异度、准确度分别为84.00%、91.11%、86.67%，两组比较，HPV的敏感度明显高于TCT（P0.05）。不同宫颈病变程度患者的HPV病毒载量比较，差异有统计学意义（P0.05）。结论 在宫颈癌的筛查中，HPV具有高敏感度，TCT具有高特异度，两种检查方法可联合应用，以减少漏诊、误诊。 　　[关键词]宫颈癌；高危型人乳头瘤病毒；液基薄层细胞学；诊断 　　[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-4721（2016）09（b）-0040-03 　　[Abstract]Objective To explore the significance of high risk human papillomavirus （HPV） detection and thinprep cytology test （TCT） examination in cervical cancer screening.Methods From January 2013 to December 2015，120 patients suspected cervical cancer were selected as study object，all patients underwent HPV test，TCT and the pathology results as gold standard.Sensitivity，specificity，accuracy of HPV，TCT in cervical cancer diagnostic were calculated and the diagnosis results of two groups were compared.According to the degree of cervical lesions patients were grouped into CINⅠ，CINⅡ，CINⅢ，cervical cancer，cervical lesions of different HPV viral load were compared.Results Sensitivity，specificity and accuracy of HPV in cervical cancer diagnostic was 96.00% and 73.33%，87.50% respectively，with 84.00%，91.11% and 86.67% respectively of TCT，the sensitivity of HPV was significantly higher than that of TCT （P0.05）.HPV viral load in patients with different degree of cervical lesions were compared，and the difference was statistically significant （P0.05）.Conclusion In the screening of cervical cancer，HPV has high sensitivity，TCT has high specificity，two kinds of inspection methods can be combined to reduce the missed diagnosis and misdiagnosis. 　　[Key words]Cervical cancer；High risk human papillomavirus；Thinprep cytology test；Diagnosis 　　宫颈癌属于临床常见妇科癌症，是最为常见的妇科恶性肿瘤之一，其发病率呈现出增高趋势，且发病年龄出现年轻化趋势，对患者的生育功能和生命安全构成了严重威胁[1-3]。早期筛查和诊断是确保宫颈癌患者得