宫颈液基细胞学联合HPV检查在宫颈病变筛查中的评价

Evaluation of Liquid-based Cervical Cytology and HPV Examination in the Screening of Cervical Lesions

目的研究人乳头瘤病毒(HPV)联合宫颈液基薄层细胞学(TCT)检测在宫颈病变筛检中的应用价值。方法整群选取2014年1—12月以424例妇科门诊就诊女性为研究对象,分别行HPV、TCT检测及阴道镜下病理活检,以病理学结果为"金标准",对宫颈HPV及TCT的单独检测,以及二者联合检测对宫颈病变筛查的方法学评价。结果 424例就诊女性患者49.5%为HPV阳性,且随着宫颈疾病病变程度不断进展,HPV阳性率也呈现升高趋势;424例TCT检查结果:宫颈不典型鳞状细胞(ASCUS)以上病变阳性率为49.3%,其中ASC105例,低度鳞状上皮内病变(LSIL)69例,高度鳞状上皮内病变(HSIL)34例,鳞状细胞癌(SCC)1例;两种方法联合对于宫颈上皮内瘤变(CINI)以上病变的筛查相对于单独检查,灵敏度(98.1%)、约登指数(0.78)及阴性预测值(93.6%)均有不同程度的提高。结论 TCT联合HPV检测对宫颈病变的筛检有着重要的临床价值。

Objective To research the application value of HPV combined with TCT in the screening of cervical lesions.Methods 424 cases of female patients diagnosed in the gynecology clinic of our hospital from January 2014 to December2014 were selected as the research objects and were given HPV and TCT detection and pathologic biopsy vaginoscopy,and the methodology of screening of cervical lesions was evaluated through the single detection of cervical HPV and TCT and combined detection of the two using the pathological results as ＂gold standard＂.Results Of 424 cases of female patients,49.5% was HPV positive,and with the continuous progress of the degree of cervical disease,HPV positive rate also showed an increasing trend,TCT examination results of 424 cases：the positive rate of above-ASCUS lesions was 49.3%,ASC occurred to 105 cases,low-grade squamous intraepithelial lesion occurred to 69 cases,high-grade squamous intraepithelial lesion occurred to 34 cases,squamous-cell carcinoma occurred to 1 case,compared with those of the single examination,the sensitivity,Youden index and negative predictive value of the combined examination in the screening of above-CINIwere improved in varying degrees.Conclusion TCT combined with HPV detection is of an important clinical value to the screening of cervical lesions.