TCT联合HPV及肿瘤标志物检测在宫颈癌中的意义

Significance of TCT combined with HPV and tumor markers for the detection of cervical cancer

目的研究薄层液基细胞学(TCT)联合高危型人乳头瘤病毒(HPV)、鳞状细胞癌抗原(SCCA)、糖类抗原(CA125)、CA19-9检测在宫颈癌中的意义。方法将86例患者分两组,宫颈上皮内瘤变(CIN)28例,58例病理结果阳性(CINⅠ、CINⅡ、CINⅢ)、子宫颈原位癌(CIS)的患者,同时进行TCT检查及HPV DNA、SCCA、CA125、CA19-9检测。对不同临床分期、病理类型TCT、HPV DNA及肿瘤标志物阳性率进行比较。结果高度病变CINⅡ、CINⅢ及CIS HPV阳性率为94.8%,与TCT的高度病变的阳性率81.1%相比,差异有统计学意义(P<0.05)。宫颈腺癌CA125、CA19-9阳性检出率高于鳞癌,差异有统计学意义(P<0.05)。宫颈鳞癌SCCA阳性检出率高于鳞癌,差异有统计学意义(P<0.05)。结论宫颈细胞学检查和HPV检测相互结合以提高检出率,肿瘤标志物及HPV DNA阳性对患者的辅助诊断、治疗及预后具有临床意义。

Objective To study the significance of thin layer liquid based cytology （TCT） combined with high risk type the human papilloma virus （HR HPV）, squamous cell carcinoma antigen （SCCA）, sugar chains antigen （CA125,CA19-9） test in the detecion of cervical cancer. Methods 86 patients were divided into 2 groups including 28 patients of cervical intraepithelial neoplasia of getting （CIN） ,58 cases of positive pathologic result（CIN I ,CIN II , CIN III ） ,CIS） ,9 patients taken TCT inspection, HPV DNA,SCCA,CA125,CA19 9 test,simultaneously. The clinical and pathologic stage for different types of TCT,HPV DNA and tumor markers were compared. Results The positive rate of high lesion CIN III ,CIN II and CIS HPV was 94.8%,which was statistically significant different from the high lesion TCT（81.1 % ） （P〈0.05）. CA125, CA19 9 positive detection rate of cervical adenocarcinoma was higher than that of squamous ceil carcinoma（P〈0.05）. SCCA positive detection rate of cervical squamous cell carcinoma was higher than that of squamous cell carcinoma（P〈 0.05）. Conclusion Cytological examination and cervical HPV test combined can improve the detection rate. Tumor markers and HPV DNA positive rate have clinical significance for assistant diagnosis, treatment and prognosis.