TCT结合高危型HPV检测筛查宫颈上皮内瘤变及宫颈癌临床观察

Clinical effect of thin-prep cell test TCT and high-risk HPV in the diagnosis of intraepithelial neoplasia and cervical cancer

目的探讨液基薄层细胞学检测(TCT)结合人乳头瘤病毒(HPV)体检筛查在宫颈上皮内瘤变及宫颈癌防治过程中的作用。方法回顾性分析我院进行TCT结合高危HPV检测763例患者的临床资料,对患者的宫颈癌检测结果进行比较分析,观察病变的宫颈癌检测准确性。结果 763例患者高危型HPV检测结果,阳性患者287例,检出准确率为28.6%;TCT检测结果阳性患者78例,准确率为64.1%;两种检测方法结合检测阳性患者129例,准确率为97.7%.结论随着宫颈病变级别的升高,高危型HPV-DNA的阳性率显著上升,TCT结合高危型HPV检测可提高宫颈上皮内瘤变及宫颈癌检出率,为宫颈癌的早期诊断提供参考依据。

Objective To study the clinical application value of screening cervical precancerous lesions of high risk human papillomavirus（HR-HPV） testing combined with thin-prep cell test,TCT in prevention of cervical lesions and cervical cancer.Methods 763 women in our hospital from Janunary 2006-Janunary 2010,were screened by HR-HPV test or thin-prep cell test,TCT.Directed biopsies under colposcopy were taken either positive in any test or both two.We compared the postive coincident rate with the the pathology test positive rate during the three technologies.Results HR-HPV positive was 287 in 763 cases,the rate of infection was 37.6%,and pathology test positive was 82 cases,the coincident rate of which was 28.6%;TCT positive was 78 cases,the rate of infection was 10.2%,and pathology test positive was 50cases,the coincident rate of which was 64.1%;HR-HPV＋TCT positive was 129 cases,and the coincident rate of infection was 97.7% in pathology test.Among each coincident rate,the differences were statistical significant（P0.05）.The rate of HR-HPVinfection CINⅠ was 23.33%（14/60）、CINⅡ42.85%（15/35）、CINⅢ50%（15/30）、SCC 85.7%（6/7）,respectively.Conclusion The positive rate of HR-HPV DNA increases significantly with the grade of cervical precancerous lesions.It is of great significance to screen in the population for HPV and TCT in a regular time span,since it could not only lower the HPV infection rate and decrease the incidence of cervical lesions,but also prevent the cervical cancer.With the improvement of level of cervical lesions,the high risk HPV-DNA positive rate increased significantly;TCT combined with high risk HPV detection,the detection could be improved by cervical intraepithelial neoplasia and cervical cancer detection rates for cervical cancer,providing basis for early diagnosis.