宫颈液基细胞学和杂交捕获Ⅱ代检测筛查宫颈癌前病变和宫颈癌

Use of hybrid capture Ⅱ and liquid-based cytology test in the screening of cervical cancer and pre-cancerous lesions

目的:评价应用杂交捕获Ⅱ代(HC-Ⅱ)检测高危型人乳头瘤病毒(HPV)和宫颈液基细胞学(LCT)筛查宫颈癌及其癌前病变的临床应用价值。方法:在中日友好医院妇产科进行宫颈癌筛查和诊治的948名妇女进行了HC-Ⅱ及LCT检查。对1项或2项结果异常者及宫颈外观呈重度炎症者进行组织病理学检查。结果:948名妇女中1项或2项结果异常者344例及2项结果均正常但宫颈外观呈重度炎症者23例,共计367例。对其进行组织病理学检查,发现宫颈炎症190例,宫颈上皮内瘤变(CIN)Ⅰ级55例、CINⅡ级41例、CINⅢ级69例和宫颈浸润癌患者12例。组织病理学≥CINⅡ组与≤CINⅠ组比较,高危型HPV感染率有显著性差异(P<0.05)。LCT检测高级别CIN的敏感性为90.98%,HC-Ⅱ检测敏感性为95.08%。LCT和HC-Ⅱ两种检测没有关联性(χ2=0.18,P>0.05),同时检测可提高宫颈高度病变的检出率。结论:LCT和HC-Ⅱ检测在临床宫颈癌及其癌前病变的筛查中具有重要价值。

Objective：To evaluate the value of hybrid capture Ⅱ （HC-Ⅱ） and liquid-based cytology test （LCT） in the screening of cervical cancer and precancerous lesions.Methods：HC-Ⅱ and LCT were done for 948 cases of outpatients in China-Japan Friendship hospital.Of them, 367 abnormal cases were detected.The sensitivity of the two methods in precancerous and cervical cancer lesions were compared.Results：Fifty-five patients with cervical intraepithlial neoplasia （CIN） 1,41 patients with CINⅡ,69 patients with CINⅢ and 12 patients with cervical cancer were found.And the high-risk human papillomavirus （HR-HPV）infection rate of people with high-grade CIN lesions and cervical cancer was higher （P〈0.05）.For the detection of the high-grade CIN lesions and cervical cancer,the sensitivity of HC-Ⅱ and LCT were 95.08% and 90.98%.The results of LCT were generally unrelated to HC-Ⅱ（X^2=0.18,P〉0.05） and LCT combined with HR-HPV testing raised the sen- sitivity of screening of cervical cancer and precancerous lesions greatly.Conclusion：LCT and HC-Ⅱ play important roles in clinical cervical cancer screening.