人乳头瘤病毒基因分型检测联合液基薄层细胞学检查的临床应用

Clinical application of human papillomavirus DNA genotyping combined with liquid based cytology examination

目的研究并探讨人乳头瘤病毒（HPV）基因分型检测联合液基薄层细胞学检测（TCT）在宫颈癌筛查中的应用价值。方法于2015年5月～2016年6月，选取120例疑似宫颈癌患者作为此次研究的对象，所有患者均接受HPV检测、TCT检查，以病理诊断结果作为金标准，计算HPV、TCT以及HPV＋TCT对宫颈癌的诊断敏感性、特异性、准确性。根据宫颈病变程度进行分组，将患者分为CIN Ⅰ级、CIN Ⅱ级、CIN Ⅲ级、宫颈癌，观察不同宫颈病变程度的HPV病毒载量，并计算宫颈病变程度与HPV病毒载量之间的相关性。结果HPV的敏感性明显高于TCT（P〈0．05），TCT的特异性明显高于HPV（P〈0．05），两种检测方法的准确性相当（P〉0．05）；HPV＋TCT的诊断准确性为95．83％，较HPV、TCT更高（P〈0．05）。宫颈病变程度与HPV病毒载量密切相关（P〈0．05），且呈正相关。结论在宫颈癌的筛查中，HPV与TCT联合诊断的准确性高，可减少漏诊、误诊。

Objective To study and discuss the significance of human papillomaviruS （HPV） DNA genotyping combined with liquid based cytology （TCT） examination in cervical cancer screening. Methods 120 cases of patients with suspected cervical cancer in May 2015 to June 2016 were selected as the study object. All the patients underwent HPV test and TCT test. The pathology result was set as the gold standard.The diagnostic sensitivity, specificity,accuracy of HPV, TCT, and HPV ＋ TCT in cervical cancer were calculated. According to the degree of cervical lesions,they were divided into CIN I ,CIN IT ,CIN m ,cervical cancer. Cervical lesions of different HPV viral load were observed, and calculate the degree of cervical lesions and the relationship of amounts of HPV load correlation were calculated. Results The sensitivity of HPV was significantly higher than that of TCT （P 〈 0.05）,the specificity of TCT was significantly higher than that of HPV,and the accuracy of the two methods for the detection of considerably（P 〉 0.05）. The diagnostic accuracy of HPV＋TCT was 95.83%,which was higher than that of HPV and TCT （P 〈 0.05）.The degree of cervical lesions was closely related to HPV viral load （P 〈 0.05）,and it was positively correlated with the degree of viral load. Conclusion In the screening of cervical cancer, the diagnostic accuracy of HPV and TCT is high.It can reduce the missed diagnosis and misdiagnosis.