高危型HPV联合TCT检测在宫颈病变Leep术后的应用价值

The joint clinical value of the high-risk HPV test and the TCT detection after the loop electrosurgical excision procedure(LEEP) for cervical lesions

目的探讨高危型人乳头瘤病毒(high-risk human papilloma virus,HR-HPV)联合液基薄层细胞学检测(liquid-based thinprep cytology test,TCT)在宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)行宫颈环形电切术(loop electrosurgical excision procedure,Leep)后的临床应用价值。方法回顾性对比分析528例患者,经术前HR-HPV、TCT检测并宫颈活检病理确诊≥CINⅠ,Leep术后接受HR-HPV联合TCT检测随访12-36个月。结果术前所有病例TCT≥ASCUS,术后3月、6月、12月、18月、24月、30月和36月随访TCT异常率分别为0.12%(1/528)、2.84%(15/528)、1.33%(7/528)、1.17%(6/528)、0.76%(4/528)、0.38%(2/528)、0%;HR-HPV阳性率分别为0%(未查)、26.89%(142/528)、19.32%(102/528)、12.12%(64/528)、6.06%(32/528)、3.60%(19/528)、2.46%(13/528);术后病变持续或复发的23例,HR-HPV联合TCT双项检测病理诊断符合率为91.30%。结论 Leep术后HR-HPV联合TCT检测对评判手术效果及术后随访、预防宫颈病变复发具有较高的临床应用价值。

Objective To investigate the clinical application value of the high-risk human papillomavirus （high-risk human papilloma virus, HR-HPV） and the ThinPrep cytology （liquid-based thinprep cytology test, TCT） detection of cervical intraepithelial neoplasia-like lesions （cervical intraepithelial neoplasia,CIN） after the cervical loop electrosurgi- cal excision procedure （loop electrosurgical excision procedure,LEEP）. Methods A retrospective comparative ahalysis of 528 patients that had preoperative HR-HPV,TCT detection and cervical biopsy diagnosed ≥ CIN I;and had postop- erative TCT and HR-HPV detection followed up for 12-36 months post LEEP. Results TCT ≥ASCUS during pre- operation for all cases analysed. During post operation, the TCT abnormal rates were 0. 12% （1/528）, 2.84% （15 / 528） ,1.33% （7/528）,1.17%/00 （6/528）,0. 76% （4/528）,0.38% （2/528） ,0% ;and the HR-HPV positive rates were 0% （unchecked）,26.89% （142/528）,19.32% （102/528）,12.12% （64/528）,6.06% （32/528）,3.60% （19/528）,2. 46% （13/528） for 3 months,6 months,12 months,18 months,24 months,30 months and 36 months follow-up detec- tion respectively after LEEP. For the sample of 23 patients with persistent or recurrent postoperative lesions,the patho- logical diagnosis rate of HR-HPV test and TCT detection was 91.30%. Conclusion The post Leep HR-HPV test and TCT detection has a high clinical application value in evaluating the surgery outcome and postoperative follow up, and in preventing the recurrence of cervical lesions.