人染色体端粒酶RNA基因、人乳头状瘤病毒、薄层液基细胞学检查联合检测在宫颈癌筛查中的应用价值

Clinical values of combined detection of human telomerase RNA gene,human papilloma virus and thin layer liquid based cytology test in cervical cancer screening

目的探讨联合应用hTERC、HPV检测及液基细胞学检查在宫颈癌筛查中的应用价值。方法收集2013年1月-2016年6月因宫颈疾病接受TCT检查的280例患者,进行高危HPV感染检测、hTERC基因扩增FISH检测及阴道镜下病理活组织检查,以病理学结果为金标准,将患者分为5组:炎症组(非CIN)、CIN1组、CIN2组、CIN3组和浸润癌组。比较TCT、hTERC、HPV检测在CIN筛查中的价值。结果 5组TCT检查与病理学结果吻合率分别为90.9%、59.6%、70.5%、66.7%及80.0%;炎症组高危HPV感染率低于CIN组,差异有统计学意义(P<0.01),CIN组与宫颈浸润癌组差异无统计学意义(P>0.05);hTERC基因扩增率高级别CIN组及浸润癌组明显高于低级别CIN组;联合应用3种检测手段灵敏度和特异度最高,分别为98.5%和92.3%。结论 3种方法联合检测优于单一方案,可以极大地提高宫颈癌高度病变的检出率。

Objective To study the application values of combined detection of human telomerase RNA gene（ h TERC）,human papilloma virus（ HPV） and liquid based cytological examination in cervical cancer screening. Methods To collect 280 patients who accepted thin layer liquid based cytology test（ TCT） examination during January 2013-June 2016 for HPV infection,h TERC gene amplification FISH test and pathological biopsy under colposcopy; according to pathological results,the patients were divided into five groups： inflammation group（ non-CIN）,CIN1,CIN2,CIN3 and group infiltrating carcinoma. To compare the value of TCT,h TERC and HPV detection in CIN screening. Results The concordance rates of the 5 TCT examinations with pathological results were 90. 9%,59. 6%,70. 5%,59. 6% and 80. 0%; the high-risk HPV infection rate of inflammation was lower than that of CIN group,and the difference was statistically significant（ P 〈 0. 01）; there was no statistical significance on the difference between the CIN group and the infiltrating carcinoma group（ P 〉 0. 05）; CIN and cervical incursive carcinoma group has no statistically significant difference（ P 〉 0. 05）; h TERC gene amplification rate of high-grade CIN and invasive cancer group was significantly higher than that of low level CIN group. Combined use of three kinds of detection means,with the highest sensitivity and specific degree of 98. 5% and 92. 3%. Conclusion Joint detection of the three methods was superior to a single,which could greatly improve the detection rates of advanced cervical lesions.