高危型人乳头瘤病毒辅助液基薄膜细胞学对宫颈病变筛查的临床价值

The Clinical Value of High-risk Human Papillomavirus Assisted Liquid-based Cytology Test for Cervical Lesions Screening

目的采用高危型人乳头瘤病毒(HPV)辅助液基薄膜细胞学检查(LCT)进行宫颈病变筛查,探讨高危型人乳头瘤病毒辅助液基薄膜细胞学对宫颈病变筛查的临床价值。方法选择自愿接受宫颈人乳头瘤病毒和液基薄膜细胞学检查的妇女550例,进行高危型人乳头瘤病毒辅助液基薄膜细胞学检查,与病理活检检查结果进行对比分析。结果 550例筛查者中LCT检查异常者为267例(48.55%),高危型HPV阳性者为196例(35.64%),对比二者的筛查结果,发现高危型HPV阳性率在LCT阴性者为29.3%、ASCUS或AGUS为34.3%、ASCUS-H为46.2%、LSIL为65.0%、HSIL为85.7%、SCC为100%。各结果间比较,c2=54.59,P<0.05,差异有统计学意义。高危型HPV和LCT双阳性者在鳞癌或腺癌患者中占100%,CIN-Ⅲ患者中占78.9%,CIN-Ⅱ中占71.4%,CIN-Ⅰ中占64.8%,而在活检正常或炎性反应者中仅占5.0%,组间比较,差异有显著性(c2=31.44,P<0.05)。结论高危型HPV感染与宫颈病变程度具有相关性,随患者宫颈病变级别越高,高危型人乳头瘤病毒辅助液基薄膜细胞学检查的结果与病理诊断符合率越高。二者检查异常的病例配合病理检查,能及早发现宫颈癌的早期病变。

Objective To study the clinical value of high risk human papillomavirus（HPV）assisted cytology liquid--based cytology test （LCr） for screening of cervical lesions.Methods 550 women were selected to accept high risk HPV and LCT to diagnose cervical lesions.All the cases signed informed consent.And the diagnoses high risk HPV, LCT and pathology were analyzed. Results There were 267 abnormal cases （48.55%） in LCT screening,and 196 positive cases（35.64%）in high--risk HPV screening. The high--risk HPV positive rate was 29.3% in those cases who were found negative in the LCT.And it was 34.3% in ASCUS or AGUS,46.2% in ASCUS--H, 65.0% in LSIL,85.7% in HSIL,and 100% in SCC.Comparison of the results,X^2=54.59,P〈0.05,there were significant difference between them.High--risk HPV-positive and LCT in the squamous cell carcinoma or adenocarcinoma accounted for 100%,CIN--III patients accounted for 78.9%,CIN-II accounted for 71.4%,CIN-I in 64.8%, while in normal or biopsy Inflammatory response only 5.0%.The difference was significant（X^2= 31.44,P〈0.05）between those groups.Conclusion High--risk HPV infection and cervical lesions are relevant.The higher the level of cervical lesions in patients with the higher consistency between pathological diagnoses,high--risk HPV assisted LCT screening.It can rise the rate of diagnose of cervical cancer in the early lesions,using high--risk HPV assisted LCT screening,then abnormal biopsy.