高危型HPV筛查和液基细胞学检查在宫颈病变筛查中的应用

Application of high-risk HPV screening combined with liquid-based cytologic test in cervical lesion

目的评价人乳头状瘤病毒HPV-DNA检测和液基细胞学(LBP)检查对宫颈病变筛查的临床价值。方法以常规门诊就诊的1 025例患者为研究对象,分别行高危HPV筛查和LBP检查及阴道镜下病理活检,以阴道镜下病理活检为"金标准",对两种方法进行评价。结果 1 025例患者中,高危型HPV阳性为141例(13.76%),CINⅠ为15.66%、CINⅡ为65.12%、CINⅢ为83.33%、SCC为100.00%,组间阳性率比较差异有统计学意义(P<0.05)。LBP结果中ASC检出率为11.41%、LSIL为6.24%、HSIL为2.63%、SCC为1.07%,病理学检查符合率分别为26.50%、76.56%、100.00%、100.00%,差异有统计学意义(P<0.05)。结论 HPV基因分型检测联合LBP可提高宫颈病变检出率,降低漏诊率。高危型HPV联合LBP检查对宫颈癌的防治有重要临床意义。

Objective To evaluate the clinical value of liquid-based cytologic test and human papillomavirus-DNA in detecting cervical lesion. Methods A total of 1 025 women were selected as the research object and taken high-risk HPV screening, LBP examination and colposcopy biopsy. Colposeopy biopsy was considered as ＂gold standard＂. Results Of 1 025 cases,high-risk HPV positive rate was 13.76%, high-risk HPV positive rate was 15.66% in patients with lesions CIN Ⅰ ,65.12% in CIN Ⅱ , 83.33% in CIN Ⅲ, 100.00% in SCC, the difference was significant （P〈0.05）. LBP examination results showed that detection rate of lesion in atypical squamous cell （ASC） was 11.41%,6.24% in low squamous intraepithlial lesion,2.63% in high squamous intraepithlial lesion, 1.07% in squamous intraepithlial lesion. Pathological examination coincidence rates were 26.50%,76.56%, 100.00%, 100.00%,the difference was significant （P〈0.05）. Conclusion High-risk HPV screening com- bined with LBP can improve the positive rate and reduce the rate of misdiagnosis. Combination detection with high-risk HPV and LBP is important in prevention and treatment of cervical cancer.