HPV基因分型、TCT检测在社区妇女宫颈疾病筛查中的意义

Significance of HPV Genotyping and TCT Test in the Screening of Cervical Diseases in Community Women

目的了解社区育龄妇女人乳头瘤病毒(HPV)感染的现状,探讨HPV基因分型检测和薄层液基细胞学(TCT)检测对社区妇女宫颈癌及癌前病变筛查的意义。方法对社区2024例已婚育龄妇女进行HPV基因分型检测和TCT检测,对检测结果异常的部分女性进行阴道镜检查,对病变部位进行活检取材行病理学检查。结果 2024例女性中HPV分型检测阳性者216例,检出率10.67%,其中高危型197例,占91.2%,低危型19例,占8.8%,高危型中16型和52型检出率最高;TCT检测阳性数121例,阳性率6.0%;HPV阳性的女性中阴道镜及活检阳性率为45.45%,TCT阳性者中活检阳性率46.91%,HPV/TCT并联试验阳性者中活检阳性率42.31%;CIN各分级中TCT阳性率均为100%、HPV的阳性率除CINⅠ外也均为100%。结论本社区育龄妇女HPV感染率较高,HPV基因分型检测和(或)TCT检测可早期筛查社区妇女宫颈癌和上皮内瘤变。

Objective To understand the infection status of human papilloma virus（HPV） in child- bearing age women of community,and to investigate the clinical application of HPV genotyping and thin- layer liquid- based cytology（TCT） for screening of cervical cancer and precancerous lesions of women in the community. Methods HPV genotyping and TCT detection were performed in 2024 married women of child- bearing age in the community, and the cases with abnormal TCT or positive HPV received biopsy and pathological examination under colposcope. Results Among 2024 cases, 216 cases were found with positive HPV, the detection rate was 10.67%.Among which 197 cases were infected by high risk type, accounting for 91.2%, 19 cases were infected by low risk type, accounting for8.8%. The detection rates of type 16 and type 52 were the highest in high risk type. 121 cases were TCT positive, the positive rate was 6%.The positive rate of biopsy under colposcope was 45.45% in HPV positive women and 46.91% in TCT positive women, While, in cases with positive HPV/TCT parallel test it was 42.31%. The positive rate of TCT in different CIN grades were all 100%, and the positive rate of HPV also was 100% except CIN I. Conclusion The HPV infection rate of child- bearing age women in our community is high. Detection of HPV genotyping and（or） TCT can help us to find cervical cancer and epithelial neoplasia in the community in early stage.