高危型人乳头状瘤病毒DNA、液基薄层细胞检测在宫颈癌及前期病变诊断中的临床价值

Clinical value of high-risk human papillomavirus DNA test,liquid-based cytology test in diagnosis of cervical cancer and precancerous lesion

目的：探讨高危型人乳头状瘤病毒（HPV）DNA检测联合宫颈细胞学检查对宫颈癌前病变筛查的临床意义。方法5080名女性均在2013年2月～2014年1月选择在本院就诊并进行宫颈癌前病变筛查,对其进行宫颈细胞学检查、高危型HPV DNA检测、阴道镜下行宫颈活检,使用统计学方法分析检测结果。结果经组织病理检查确诊ASC-US（不能明确意义的非典型鳞状上皮细胞）组318例,LSIL（低度鳞状上皮内病变）组26例,HSIL（高度鳞状上皮内病变）组52例,浸润癌组6例,HPV DNA＋液基薄层细胞检测（TCT）检测宫颈病变的灵敏度及阴性预测值高于高危型HPV DNA检测及TCT,TCT检测宫颈病变的特异度高于高危型HPV DNA及HPV DNA＋TCT检测,差异均有统计学意义（P〈0.05）。结论在宫颈癌的筛查中,高危型HPV DNA＋TCT检测的灵敏度及阴性预测值均较高,对宫颈癌前病变筛查有积极意义。

Objective To investigate the clinical significance of high-risk human papillomavirus （HPV） DNA test combined with cytology inspection in the screening of cervical precancerous lesions. Methods 5080 women were selected from February 2013 to January 2014 in our hospital,they were given screen of cervical precancerous lesions.Cervical cytology,high-risk HPV DNA testing,colposcopy and cervical biopsy were done in them,and the results were analyzed with statistical methods. Results ASC-US （atypical squamous meaning is not clear epithelial cells） group of 318 cases, LSIL （low-grade squamous intraepithelial lesions） 26 cases of group,HSIL （high-grade squamous intraepithelial lesion） group of 52 cases,6 cases of invasive group confirmed by histopathological examination. Sensitivity and negative predictive value of HPV ＋TCT （liquid-based cytology test） to detect cervical lesions were higher than those high-risk HPV DNA and TCT,the specificity of TCT detection of cervical lesions was higher than high-risk HPV DNA and HPV DNA＋ TCT,the difference was significant （P〈0.05）. Conclusion The sensitivity and negative predictive value of high-risk HPV DNA testing combined with cytology testing in the cervical cancer screening are higher,and has positive implications for screening for cervical lesions.