高危HPV病毒分型与液基细胞学检查在早期宫颈病变筛查中的临床价值

High-risk HPV virus sub-type and liquid-based cytology analysis in screening of early cervical lesions

目的:比较早期宫颈病变筛查方法高危型HPV病毒分型(HR-HPV)与液基细胞学检查(TCT)结果的差异,探讨两种方法联合检测对宫颈癌及癌前病变筛查的临床应用价值。方法:回顾性分析我院1 384例宫颈癌及癌前病变筛查结果,结合病理学诊断,比较HR-HPV、TCT检测结果差异,并比较两种方法单独及联合筛查的灵敏度。结果:1 384例中炎症及正常组HR-HPV阳性率为3.6%,CIN以上病变HR-HPV阳性率为57.0%,有统计学差异(P<0.05);HR-HPV阴性、单一阳性及复合阳性检测炎症、CIN1及CIN1以上病变的分布比较差异有统计学意义(χ2=694.22,P<0.05);35例TCT误诊患者HR-HPV阳性8例,26例TCT漏诊患者HR-HPV阳性15例,TCT、HR-HPV及联合检测灵敏度分别为94.3%、57.0%、98.0%。结论:HR-HPV筛查可弥补TCT检查的不足,两种方法联合检测可提高宫颈癌及癌前病变的筛查灵敏度。

Objective. To compare the effect of high-risk HPV virus typing （HR-HPV） and liquid based cytology （TCT） in early screening of cervical lesions. Methods. Combined with pathological diagnosis, screening results from 1 384 cervical cancer patients in our hospital were retrospectively analyzed. The sensitivity of HR-HPV, TCT and combination detection was compared. Results. Out of 1 384 cases, HRHPV positive rate of inflammation and normal patients was 3.6%, HR-HPV positive rate was 57.0% in patients with lesions more severe than CIN1, the difference was significant （P〈0.05）. There was significant difference in detection rate among HR-HPV-negative rate, single positive rate and combination positive rate during detection of inflammation, CIN1 lesions and lesions more severe than CIN1 （x^2 = 694.22, P〈0.05）. There were 35 cases misdiagnosed by TCT, including 8 cases with HR-HPV positive; while there were 26 cases missed by TCT, including 15 cases of with HR-HPV positive. The sensitivity of TCT was 94.3%, HR-HPV was 57.0%, and combination detection was 98.0%. Gonclusion： HR-HPV screening provide supplement for TCT, the combination detection can increase sensitivity of screening.