液基薄层细胞学检测联合人乳头瘤病毒基因分型检测在宫颈病变筛查中的应用价值评估

Application of TCT detection combined with HPV genotyping in cervical lesion screening

目的:探讨液基薄层细胞学检测(TCT)联合人乳头瘤病毒(HPV)基因分型检测在宫颈病变筛查中的作用。方法:2012年6月至12月,对我院432名TCT、高危型HPV检查阳性及临床怀疑宫颈有病变的患者行阴道镜下取宫颈活检,并对资料进行分析。结果:432名患者中病理检查异常者为68例(阳性率15.74%);行TCT检查异常者为80例(阳性率18.51%),其中病理学异常者45例,占总病理学异常患者的66.17%;行高危型HPV-DNA检测阳性者为116例(阳性率26.85%),其中病理学异常者53例,占总病理学异常患者的77.94%;68例病理异常的患者中,TCT联合高危型HPV检查阳性病例为58例,检出率为85.29%。TCT检出率与联合检查的检出率进行统计学分析,差异具有统计学意义(χ2=6.762,P=0.0092)。HPV检出率与联合检查的检出率进行统计学分析,差异具有统计学意义(χ2=4.917,P=0.027)。TCT和HPV-DNA检查的阳性率随宫颈病变严重程度的增高而升高。结论:TCT联合HPV基因分型检测可提高宫颈病变检出率,为宫颈病变的早期诊断提供重要的参考依据。定期进行TCT及HPV筛查,不仅可以降低HPV感染发病率,减少宫颈病变发病率,也可以防止宫颈癌的发生。

Objectives： To study the clinical application value of high risk human papilloma virus （HR- HPV） test combined with thin - prep cell test in screening cervical precancerous lesions. Methods： 432 women patients who were admitted into our hospital from January, 2012 to December, 2012 were screened by HR - HPV test and thin - prep cell test. Directed biopsies under colposcopy were taken and analyzed. Results： 80 cases of TCT were positive, with the infection rate of 18.15%. 45 cases of pathology test were positive, with the coincident rate of 66. 17% ; 116 of 432 cases were HR - HPV positive with the infection rate 26. 85%. 53 cases of pathology test were positive, with the coincident rate of 77.94% ; 58 cases were HR - HPV ＋ TCT positive, with the coincident infection rate of 85. 29%. The differences of the coincident rates were statistically significant （P 〈 0.05）. Conclusions： Cervical intra -epithelial neoplasia and cervical cancer detection rates could be improved by TCT com- bined with high risk HPV detection, which can provide scientific basis for early diagnosis. It is of great significance to have regular TCT and HPV test to lower the HPV infection rate and to decrease the incidence of cervical lesions and cervical cancer.