宫颈刮片、阴道镜及HPV检测在宫颈癌筛查中的体会

Clinic experience PAP smear,colposcopy and HPV test in the screening of cervical cancer

目的:总结宫颈刮片、阴道镜及HPV检测在宫颈病变诊断中的临床经验,对宫颈癌筛查提出合理化建议。方法:对3种方法任何一项检测异常者行阴道镜下病理活检及宫颈管搔刮,以组织学诊断作为金标准。对212例病理结果阳性(CINI、CINII、CINIII、宫颈浸润癌)的患者,比较3种方法的检出敏感度,及在细胞学及阴道镜检查中漏诊的临床体会。结果:212例病理结果阳性者中,宫颈刮片阳性者151例,敏感度为71.23%,阴道镜阳性者167例,敏感度为78.77%,两者阳性检出率相比无显著性差异(P>0.05)。高危型HPV感染者182例,敏感度83.02%,与阴道镜的敏感度相比,无显著性差异(P>0.05),与宫颈刮片相比,有显著性差异(P<0.05)。结论:宫颈癌的筛查及早期诊断,应以宫颈细胞学检查、阴道镜检查及HPV检测相互结合以提高检出率。

Objective To put forward rational suggestion of cervical cancer screening and summarize clinic experience of PAP smear, colposcopy and HPV test. Method patients and medical examination were detected by PAP smear,colposcpy and HPV test simultaneously, any case of abnormal test were diagnosed pathologically. Sensitivity of them were compared with three methods. Resuits 151 cases were positive in PAP smear whose sensitivity was 71.23%,167 cases were positive in colposcopy , the sensitivity was 78.77%,HPV test was positive in 182 cases , the sensitivity was 83.02%.The difference between PAP smear and HPV test was significant（P〈0.05）. There no significant difference between colposcopy and HPV. Conclusion The combination of PAP smear, colposcopy and HPV test can improve detective rate and accuracy. PAPsmear is an effective method in cosmically cervical cancer screening.