TCT联合HPV-DNA及端粒酶检测在宫颈癌前病变筛查中的应用

Application of TCT combined with HPV-DNA and telomerase detection in screening cervical precancerous lesions

目的研究液基薄层细胞学（TCT）联合高危型人乳头瘤病毒DNA（HPV-DNA）、端粒酶在宫颈癌前病变检测中的临床应用价值。方法对宫颈不同病变,包括慢性宫颈炎55例,宫颈上皮内瘤变（CIN）Ⅰ62例、CINⅡ112例、CINⅢ41例,同时进行TCT、HPV-DNA、端粒酶的检测,并对3项结果进行比较。结果 TCT单独检查CIN阳性率为64.6%,其中CINⅡ-Ⅲ诊断阳性率为77.8%;HPV-DNA诊断CINⅡ-Ⅲ的阳性率为96.7%,高于该组TCT的阳性率（77.8%）,差异有统计学意义（P〈0.05）;CIN端粒酶阳性表达率高于慢性宫颈炎（P〈0.05）;3项指标联合检测的灵敏度为94.0%,特异度为100.0%,阴性预测值为80.9%,阴性预测值明显高于其他2项联合检测。结论 TCT联合HPV-DNA及端粒酶检测相互可以提高检出率,对于宫颈癌前期病变的早期诊断、疾病评估、治疗及预后具有较高的临床价值。

Objective To investigate the clinical application value of thinprep cytological testing（TCT）combined with high-risk type human papilloma virus（HPV）DNA and telomerase detection in cervical precancerous lesions.Methods The patients with different cervical lesions,including 55 cases of chronic cervicitis,62 cases of intraepithelial neoplasia（CIN）Ⅰ,112 cases of CINⅡ and 41 cases of CIN Ⅲ,were simultaneously detected TCT,HPVDNA and telomerase.The detection results were compared.Results The positive rate of CIN detected by single TCT was 64.6%,in which the diagnostic positive rate of CIN Ⅱ-Ⅲ was 77.8%,the positive rate of HPV-DNA for diagnosing CIN Ⅱ-Ⅲ was 96.7%,which was higher than 77.8% of TCT in this group,the difference was statistically significant（P〈0.05）;the positive expression of telomerase in CIN was significantly higher than that in chronic cervicitis（P〈0.05）;the sensitivity in the combined detection of TCT,HPV and telomerase was 94.0%,the specificity was 100.0%,the negative prediction value was 80.9%,the negative prediction value was significantly higher than that in the combined detection of other two items.Conclusion TCT combined with HPV-DNA and telomerase detection can increase the detection rate of cervical diseases and has a higher clinical application value for the early diagnosis of cervical precancerous lesions,disease evaluation,treatment and prognosis.