液基细胞学联合荧光检测HPV在宫颈病变筛查中的作用

Value of combined detection of liquid-based cytology and HPV fluorescence test in screening of cervical lesions

目的:探讨液基细胞学联合荧光检测HPV在妇女宫颈病变筛查中的临床价值。方法:2007年12月～2008年10月对广西医科大学第五附属医院妇科门诊2 369例妇女进行TCT检查,其中331例细胞学异常(ASCUS及其以上)患者均行高危型HPV PCR荧光检测,HPV阳性者行阴道镜检查,同时镜下定位活检。以病理结果作为诊断的"金标准"。结果:2 369例妇女中,TCT阳性331例(13.97%),HPV阳性169例(7.13%),331例行阴道镜下宫颈多点活检,细胞学与病理学诊断符合率CINⅠ71.43%(40/56)、CINⅡ/Ⅲ79.25%(42/53)、浸润癌66.67%(8/12);细胞学联合HPV检测与病理组织学诊断符合率CINⅠ87.50%、CINⅡ/Ⅲ92.45%、浸润癌占100.00%。结论:宫颈病变的发生与高危型HPV感染密切相关,CIN与高危型HPV感染呈正相关,荧光HPV检测在宫颈病变筛查中可作为细胞学的辅助手段提高诊断准确性。

Objective：To explore the clinical value of combined detection of liquid-based cytology and human papillomavirus（HPV） fluorescence test in screening of cervical lesions.Methods：2 369 women underwent liquid-based cytology test from December 2007 to October 2008,and 331 cases with abnormal cytological results（ASCUS and above ASCUS） received high risk HPV fluorescence test,then the cases with positive HPV were examined by colposcopy,and cervical biopsy under guidance of colposcopy was carried out with pathological diagnosis as gold standard.Results：Among 2 369 women,331 cases（13.97%） were found with positive liquid-based cytology and 169 cases（7.13%） were found with positive HPV.331 cases underwent cervical multiple punch biopsy under colposcopy,the diagnostic coincidence rates of CINⅠ,CINⅡ/Ⅲ and invasive carcinoma between liquid-based cytology and histopathological results were 71.43%（40/56）,79.25%（42/53） and 66.67%（8/12）,respectively;the diagnostic coincidence rates of CINⅠ,CINⅡ/Ⅲ and invasive carcinoma between combined detection of liquid-based cytology,HPV fluorescence test and histopathological results were 87.50%,92.45% and 100.00%,respectively.Conclusion：Cervical lesions are related to high risk HPV infection closely,there is a positive correlation between CIN and high risk HPV infection,HPV fluorescence test can increase the accuracy as a supplementary means in screening of cervical lesions.