TCT与HPV在宫颈癌及癌前病变筛查中的应用-妇产科学专业论文.docxVIP

新疆医科大学硕士学位论文 新疆医科大学硕士学位论文 PAGE PAGE 1 TCT 与 HPV 在宫颈癌及癌前病变筛查中的应用 研究生：席凤 导师：丁岩教授 摘 要 目的: 评价宫颈液基细胞学检查(thinp rep cytologic test, TCT)与人乳头瘤病毒 (human papillomavirus, HPV)检测在宫颈癌和癌前病变筛查中的应用价值。方法:选取 妇科门诊 1013 例患者同时进行宫颈液基细胞学检查与 HPV 检测，对宫颈液基细胞 学检查或(和)HPV 检测阳性的 206 例患者在阴道镜下行宫颈组织活检并以病理结果 为标准。结果: TCT 检查与 HPV 检查结果阳性分别为 188 例和 205 例，TCT 检查阳 性结果中 ASCUS 113 例，占 11.2%；LSIL 38 例，占 3.8%；HSIL 34 例，占 3.3%； SCC 3 例，占 0.3%。HPV 检查阳性结果中 CINⅠ45 例，占 4.4%；CINⅡ42 例，占 4.1% ； CINⅢ45 例，占 4.4%；宫颈浸润癌 9 例，占 0.9%。高危型 HPV 感染 180 例，其中 单一感染 HPV16 最多(58%)，其次是 HPV18(16.6%)；多重感染中 HPV16 合并 HPV18 最多(4.8%)。HPV 检查 CINⅡ、CINⅢ及宫颈浸润癌的检出率明显高于 TCT 检查， 差异有统计学意义。结论: 宫颈液基细胞学检查与 HPV 检查是目前宫颈癌筛查较好 的方法，将宫颈液基细胞学检查与 HPV 检查技术联合进行宫颈癌及癌前病变早期筛 查，可提高检出率。 关键词： 宫颈液基细胞学；HPV；阴道镜； 宫颈癌；筛查 The applications of TCT and HPV in cervical cancer and cervical precancerous lesions screening Postgraduate:Xi Feng Supervisor:Prof.Ding Yan Abstract Objective: To evaluate the value of applications of TCT and HPV in cervical cancer and cervical precancerous lesions screening Methods: There are 1013 women selected from gynecology clinic taken TCT and HPV screening,206 women among them who got positive results will refer colposcopic biopsies,by standardizing on pathological findings. Results: TCT and HPV screening positive results are 188 and 205 women respectively.TCT check the positive results ASCUS 113 cases （ 11.2%);LSIL 38 cases( 3.8%);HSIL 34 cases（ 3.3%);SCC 3 cases( 0.3 %). Check the results of HPV-positive CINⅠ 45 cases( 4.4%);CINⅡ 42 cases( 4.1%);CINⅢ 45 cases( 4.4%);9 cases of invasive cervical carcinoma( 0.9%). High-risk HPV infection in 180 cases,of which up to a single HPV16 infection (58%),followed by HPV18 (16.6%);multiple merger HPV18 and HPV16 infection in most (4.8%). HPV Check CINⅡ CINⅢ and invasive cervical cancer detection rate was significantly higher than the TCT examination,the difference was statistically significant. Conclusion: TCT and HPV screening are superior screenings nowadays. The combination of TCT and HPV for cervic