HPV与TCT联合作为宫颈癌初筛的临床意义

Clinical significance of combination of HPV and TCT for preliminary screening of uterine cervix cancer

目的:探讨宫颈液基细胞(TCT)与人乳头状病毒(HPV)联合作为宫颈癌的初筛是否提高宫颈病变及宫颈癌的筛查率。方法:随机取门诊就诊病人要求宫颈癌筛查或有性生活一年以上的19～60岁妇女,作为研究组和对照组各2 000例。HPV检测:采用由美国Digene公司所创的杂交捕获(HC2)实验。其原理是利用化学发光对抗体捕获的信号加以放大。液基细胞(TCT)检查:由美国赛迪公司和北京英硕力新柏科技有限公司提供。结果:研究组:2 000例病人中,高危型HPV感染例数为230例,占11.5%。其中HPV16型感染98例;18型感染70例,其余为31、33、35、39、45、51、52、56、58型。HPV阳性、细胞学ASCU-S,最后阴道镜活检原位癌2例,CINⅠ级2例,CINⅡ级2例,CINⅢ级2例。对照组:细胞学ASCU-S,然后阴道镜活检+HPV检测,检出CINⅠ级2例,CINⅡ级1例。研究组检出明显高于对照组。结论:将高危HPV和TCT技术相结合初筛应用于早期宫颈癌及癌前病变中,更具备有严谨科学性和准确性,不仅提高宫颈病变和宫颈癌的筛查率而且又经济而高效,具有一定的临床使用价值。

Objective ： To observe whether the combination of high - risk type Human papilloma - virus （HPV） and thinprep cy- tology test （TCT） could raise the preliminary screening rate for cervix pathological changes and uterine cervix cancer. Methods： A total of 4 000 women were randomly recruited from the out - patient clinic patients between 19 and 60 years old who wanted uterine cervix cancer preliminary screening or had sex life above a year. They were equally distribute to the treatment group and the control group. HPV detection： adopted hybridcapture （ HC2 ） test created by American Digene Company. TCT ： provided by American sadie company and Beijing TCT Med- ical Co. Ltd. Results： The treatment group： 230 （11.5%） high - risk type HPV cases were found： HPV16 cases was 98, HPV18 cases was 70, the rest were the types of 31, 33, 35, 39, 45, 51, 52, 56, 58. HPV positive, cytology ASCU-S, and colposcope biopsy- carcinoma in situ was 2 cases. CIN I was 2 cases, CIN I1 was 2 cases, CINm was 2 cases. The control group： 2 cases of CIN I and 1 case of CIN II were found by colposcope biopsy and HPV test and cytology ASCU - S. The preliminary screening rate of the treatment group was obviously exceed the control group. Conclusion： The application of high -risk type HPV combining TCT for the uterine cervix cancer or pre- cancerous lesion is more scientific and accurate. It could not only raise the preliminary screening rate for cervix pathological changes and uter- ine cervix cancer, but also economic and efficient. It has certain clinical value.