薄层液基细胞学与人乳头瘤病毒联合检测在宫颈上皮病变筛查中的应用

TCT combined with HPV testing in screening of cervical intraepithelial lesions

目的探讨薄层液基细胞学(TCT)与人乳头瘤病毒(HPV)联合检测在宫颈上皮病变筛查中的应用。方法对在我院妇科门诊就诊和体检进行TCT联合HPV检测的妇女,选择单纯TCT阳性者121例为TCT组,单纯HPV阳性者169例为HPV组,两者均阳性者92例为TCT联合HPV组,三组均经阴道镜下取活检,以组织病理学为金标准,比较三组与组织病理学诊断的阳性预测值。分析TCT联合HPV检测双阳性与TCT和HPV单纯阳性在宫颈上皮病变筛查效果中有元差异。结果 TCT组、HPV组、TCT联合HPV组与组织病理学诊断的阳性预测值分别为57.02%、30.77%、75.00%。TCT联合HPV组与TCT组比较差异有统计学意义(x^2=7.40,P<0.05),TCT联合HPV组与HPV组比较差异有统计学意义(x^2=46.87,P<0.05)。结论 TCT联合HPV检测筛查宫颈上皮病变明显优于TCT和HPV的单纯检测,是宫颈癌及癌前病变筛查较理想的方法。

Objective To study the application of combined TCT with HPV testing in screening of cervical intraepithelial lesions. Methods In women who received the combined TCT with HPV testing in gynecology clinic in our hospital, 121 women with alone TCT positive were used as TCT group;169 women with alone HPV positive as the HPV group,92 women with both TCT and HPV positive as the combined TCT with HPV group. Three groups were confirmed by colposeopic biopsy, and the histopathology was used as the gold standard. The results of pathological diagnosis were compared with the results of three testing. The positive results of three testing in cervical intraepithelial lesions were compared. Results The positive predictive value in TCT group, HPV group and the combined TCT with HPV group were 57.02% and 30. 77% , 75.00% respectively. There was significant difference between the combined TCT with HPV group and TCT group （Х^2 = 7.40, P 〈 0.05 ） ; and between the combined TCT with HPV and HPV group （Х^2 = 46. 87, P 〈 0. 05）. Conclusion The TCT combined with HPV screening test is superior to alone TCT and HPV testing in screening of cervical intraepithelial lesions and is the ideal method for screening of cervical cancer and precancerous lesions.