阴道镜联合HPV-DNA检测对宫颈不典型鳞状细胞的诊断价值

Value of colposcopy combined with HPV- DNA test in diagnosis of cervical atypical squamous cells

目的:探讨阴道镜联合人乳头瘤状病毒-脱氧核糖核酸(human papilloma virus deoxyribo nucleic acid,HPVDNA)检测对宫颈不典型鳞状细胞的诊断价值。方法:选取2012年3月至2015年3月进行治疗的宫颈不典型鳞状细胞患者130例为研究对象,所有患者均行阴道镜下多点活检及HPV-DNA检测。结果:130例宫颈不典型鳞状细胞患者中,病理检查诊断为炎症为87例(66.92%),宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅰ14例(10.77%),CINⅡ17例(13.08%)、CINⅢ8例(6.15%),鳞癌4例(3.08%)。HPV阳性58例,阳性率为44.62%(58/130),HPV阴性72例,阳性率为55.38%(72/130)。HPV-DNA阳性组中CIN的检查率高于阴性组,差异具有显著性(P<0.05)。HPV检测的敏感度为72.09%(31/43),阴性预测值为83.33%(60/72)。阴道镜对CIN诊断符合率为76.79%(43/56),诊断敏感度为74.42%(32/43),阴性预测值为85.14%(63/74)。结论:临床应用阴道镜联合HPV-DNA检测对宫颈不典型鳞状细胞进行有效的筛查,对及早发现宫颈及癌前病变、降低宫颈癌的发生率和死亡率具有重要的作用,值得临床推广及应用。

Objective：o discuss the value of colposcopy combined with human papilloma virus deoxyribo - nucleic acid （ HPV - DNA） test in diagnosis of cervical atypical sqnamous cells （ASC）. Methods ： 130 cases of patients with cervical atypical squamous cells （ ASC ） treated in our hospital from March 2012 to March 2013 were chosen to undergo muhiple punch biopsy under colposcopy and HPV - DNA test. Results： In the 130 cervical ASC patients, the pathological diagnosis confirmed that there were 87 cases of inflammation （ 66.92 % ）, 14 cases of cervical intraepitheli- al neoplasia （CIN） Ⅰ （ 10.77 % ） , 17 cases of CIN Ⅱ （ 13.08 % ） , g cases of CIN Ⅲ （6.15 % ） and 4 cases of squamous cell carcinoma （3.08 % ） ; there were 58 cases of HPV - positive （44.62 % ） and 72 cases HPV - negative （55.38 % ）. The detection rate of CIN in HPV - positive group was significantly higher than that in the HPV - negative group （ P 〈 0.05 ）. The sensitivity of HPV test was 72.09% （ 31/43 ） and the negative predictive value was 83.33 % （60/72）. The diagnostic coincidence rate of colposcopy on CIN was 76.79 % （43/56）, the diagnostic sensitivity was 74.42 % （32/43） and the negative predictive value was 85.14 % （63/74）. Conclusion： The clinical application of colposcopy combined with HPV - DNA test has been proven to be an effective tool to detect and screen cervical ASC and play an important role for early detection of premalignant cervical lesion and the reduction of incidence and mortality of cervical cancer, worthy of clinical promotion and applications.