HR-HPV联合TCT检测在宫颈病变筛查中的应用

Application of HR-HPV combined with TCT in cervical lesion screening

目的评价高危型人乳头瘤病毒(HR-HPV)检测联合薄层液基细胞学(TCT)检查在宫颈病变筛查中的应用效果。方法对2012年1月至2013年1月在该院活检结果大于或等于子宫颈上皮内瘤样病变1级的328例阳性患者,采用HR-HPV联合TCT检测,以阴道镜下活检的病理结果为确诊标准,比较2种方法联合检测在宫颈病变筛查中的意义。结果 328例患者中,TCT检测细胞学异常[≥无明确诊断意义的非典型鳞状上皮细胞(ASC-US)]诊断阳性率为59.45%(195/328),与病理诊断结果比较,差异有统计学意义(χ2=49.96,P<0.01)。HR-HPV检测阳性率为76.83%(252/328),与病理诊断结果比较,差异无统计学意义(χ2=3.37,P>0.05)。328例患者中HR-HPV联合TCT检测结果阳性122例,阳性率为37.20%,结果阴性仅3例。2种方法联合检测阳性率与TCT单项检查比较,差异有统计学意义(χ2=32.53,P<0.05);与HR-HPV单项检测比较,差异有统计学意义(χ2=105.12,P<0.05)。结论 HR-HPV检测的准确率高于TCT检测。二者联合使用,能明显提高检出率和筛查效率。对于二者均阴性者,可以基本排除宫颈病变。二者与阴道镜下多点活检术结合可提高宫颈病变诊断的准确性。

Objective To assess the application effect of high-risk human papillomavirus（HR-HPV） and TCT test in cervi-cal lesion screening. Methods From January 2012 to January 2013 ,a total of 328 positive female patients biopsied under the colposcope and diagnosed（≥CINI） were detected by HR-HPV and TCT. The diagnostic criteria refered to the pathological find-ings of biopsy under colposcopy. and then it was analyzed the effect in cervical lesion screening for the above detecting method. Results In the 328 patients,the positive rate of TCT abnomity diagnosed to be 59.45%（195/328）[no less than ASC-US without clear diagnosis]. Compared to the pathological diagnosis results,it had statistical significance in difference（χ^2=49.96,P〈0.01）. The positive rate of HR-HPV test was 76.83%（252/328）,which was compared to the pathological diagnosis results,it had no sta-tistical significance（χ^2=3.37,P〉0.05）. It was found 122 positive and 3 negative cases by HR-HPV combined with TCT with the positive rate being 37.20%. The joint detection had statistical significance compared to either TCT or HR-HPV（χ^2=32.53,105.12, P〈0.05）. Conclusion The accuracy rate of single HR-HPV test was higher than single TCT test. The combination of HR-HPV test and TCT test may increase significantly detection rate and screening efficiency. Referred to the negative by the above-men-tioned two methods,it may be deemed as out of sickness.The combination of HR-HPV and TCT combined with multi-point biopsy under the colposcope may help the diagnosis of cervical lesion.