人乳头瘤病毒配合液基细胞学检测在早期宫颈癌筛查中的应用

Application of human papilloma viruse combined with liquid-based cytology detection in early screening of cervical cancer

目的：探讨宫颈液基细胞学检查（TCT）联合高危型人乳头瘤病毒（HPV-DNA）检测进行妇女宫颈癌早期筛查的价值。方法：对我院妇科门诊接受宫颈病变筛选的妇女共1845例，随机分成3组；A组，162例，进行TCT和HPV检查；B组，515例，进行TCT检查；C组1168例，仅行宫颈刮片检查。对任何一项阳性皆行阴道镜多点活检，以病理结果为金标准。结果：A组162例中，共查出CINI10例、CINⅡ～Ⅲ8例、宫颈癌1例；HPVl6．18检测阳性6例中3例细胞学筛查为阴性。经组织病理检查结果为：CINⅢ2例，筛查阳性符合率94．6％。B组共查出CINI16例、CINⅡ-Ⅲ8例，宫颈癌2例，筛查阳性符合率62．4％。C组共查出CINI5例、CINⅡ—Ⅲ2例，筛查阳性符合率22．5％。A组与B，c组相比较，差异有统计学意义（P〈0．01）。

Objective： To investigate the value of liquid-based cervical cytology（TCT）combined with high-risk types of human papillomavirus（HPV-DNA）detection in early screening cervical cancer in women. Methods： A total of 1845 women of cervical lesions screening in our hospital, were randomly divided into three groups, group A （162 cases）with TCT and HPV testing; B group （515 cases） with TCT examination and C group （1168 cases） with only cervical smear in which any positive case was perfomed colposcopy of multiple biopsy pathology（the result as the gold standard）. Results： Uncovered a total of 162 cases in the A group, there was CIN Ⅰ 10 cases,CIN Ⅱ-Ⅲ 8 cases and 1 case of cervical cancer. HPV16 of 18 six cases in A group,3 cases tested positive cytology was negative in which the result of the pathological examination was CIN Ⅲ 2 cases （screening positive coincidence rate of 94.6%）. In B group, there was CIN Ⅰ 16 cases, CIN Ⅱ - Ⅲ 8 cases and 2 cases of cervical cancer in which cervical cancer screening positive coincidence rate was 62.4%. In C group,there was CIN I 5 cases, CIN Ⅱ - Ⅲ 2 cases in which screening positive coincidence rate was 22.5%.Compared with group B and C, the difference was statistically significant in A,B and C group（P〈0.01 ）.Conclusion： TCT combined with HPV-DNA is ideal for early cervical cancer screening method.