比较人乳头瘤病毒检测与薄层液基细胞学在宫颈癌筛查中的应用价值

Compared the Value of Human Papillomavirus DNA Testing and Thinprep Cytology Test in Screening Cervical Cancer

目的比较人乳头瘤病毒DNA（human papillomavirus DNA，HPV DNA）检测与薄层液基细胞学（ThinPrep Cytology Test，TCT）在宫颈癌及癌前病变筛查中的应用价值。方法对我院妇科门诊261例宫颈疾病患者进行TCT检查和HPVDNA检测，细胞学诊断标准按照TBS（2001）分类。细胞学诊断≥ASCUS或高危型HPVDNA阳性患者建议阴道镜检查并行多点活检，宫颈病理诊断≥CIN1为阳性。结果高危型HPVDNA检测敏感性为64．1％，特异性为66．9％，TCT检查敏感性为53．1％，特异性为72．3％；高危型HPVDNA检测敏感性较TCT高，统计学有显著性差异（P〈0．05）。高危型HPVDNA检测阳性ASCUS患者，54．5％出现宫颈上皮内瘤病（CIN），显著高于高危型HPVDNA阴性组（P〈0．05）。结论HPVDNA检测在宫颈癌及癌前病变的筛查的敏感性较高，是一种有效的筛查手段；细胞学诊断Ascus患者进行HPVDNA检测可提高筛查的阳性率。

objective Compared the value of human papillomavirus DNA （HPV DNA） testing and the ThinPrep cytology test （TCT） in screening cervical cancer and precancer lesions. Methods 261 outpatients with cervical lesions in our hospital were tested by HPV DNA testing and TCT, Cytological diagnosis was used The Besthad System （2001）. Women who had TCT result of atypical squamous cells of undetermined significicance （ASCUS） or higher, or were positive for high-risk HPV DNA, were considered to have positive screening test, and reformed for colposcopy and biopsy. Results The sensitive and specificities of high risk HPV DNA testing were 64.1% and 66.9% for identifying patients with CIN1 or higher, but the sensitive and specificities for TCT were 53.1%and 72.3%, the sensitive of high risk HPV DNA testing was significance higher the TCT （P〈0. 05）. The 54.5% patients with ASCUS and positive result of high risk HPV DNA were found to have cervical intraepithelial neoplasia （CIN）, it was higher than with negative result of high risk HPV DNA test （P〈0. 05）.Conclusions HPV DNA testing is effective methods for cervical cancer screening. The patients with ASCUS should make HPV DNA test.