LCT及HR-HPV诊断宫颈病变的临床价值

Clinical Value of LCT and HR-HPV in the Diagnosis of Cervical Lesions

目的探讨LCT和HR-HPV对宫颈病变的诊断价值。方法对20479例患者行LCT检查,LCT阳性者行HR-HPV检测及电子阴道镜下宫颈活检组织病理检查,以组织病理学结果作为诊断的金标准,比较LCT阳性结果、HR-HPV检测结果与阴道镜下宫颈活检病理结果的符合率。结果1)LCT结果为ASCUS、LSIL、ASCH、HSIL与阴道镜下宫颈活检病理结果的符合率分别为54.55%、62.65%)、88.24%、92.99%。其HR-HPV阳性率分别为71.64%、80.56%、88.24%、92.86%。差异有显著性(P<0.001)。2)HR-HPV阳性组与阴性组比较,高级别宫颈病变的检出率分别为48.14%、17.39%,经卡方检验,P<0.001,差异有显著性。结论高危型人乳头瘤病毒检测对于细胞学诊断为非典型鳞状细胞的患者有重要的分流价值。

Objective To study liquid-based cervical cytology and high risk human papilloma virus testing and biopsy in the diagnosis, discusses the cervical liquid based cytology and high-risk human papilloma virus detection value to the diagnosis of cervical lesions. Methods Retrospective analysis of the Affiliated Hospital of Qingdao University outpatient 20479 cases of LCT screening from January 2013 to January 2014. LCT positives were further investigated by HRHPV testing and colposcopy cervical biopsy pathology, compare the accuracy of the LCT positive results and HR-HPV test results with cervical biopsy and colposcopy results with pathology detection results as the gold standard of diagnosis.Results 1）The consistence rates of ASCUS, LSIL, ASCH, HSIL by LCT and colposcopic multiple biopsies were54.55%, 62.65%, 88.24%, 92.99%. HR- HPV infection rates of ASCUS, LSIL, ASCH and HSIL respectively were70.00%, 88.71%, 84.91%, 89.66%. There was seriously statistical significance（P〈0.001）.2）HR-HPV positive and negative groups compared with the high-level cervical lesion detection rates were 48.14%, 17.39%（P 0.001）. There was seriously statistical significance. Conclusion Liquid-based cytology and high-risk human papillomavirus detection is an effective screening method for detecting cervical lesions, higher diagnostic accuracy of both joint detection. High-risk human papillomavirus detection for cytologic diagnosis of atypical squamous cells of patients has significant shunt value.