薄层液基细胞学、人乳头瘤病毒检测联合阴道镜检查在宫颈癌临床筛查中的应用价值

Application value of liquid-based cytology test and human papillomavirus detection combined with colposcopy in clinical screening of cervical carcinoma

目的探究薄层液基细胞学检查与人乳头瘤病毒(HPV)检测联合阴道镜检查在宫颈癌临床筛查中的应用价值。方法选取该院在2014年6月-2016年6月期间采用薄层液基细胞学检查与HPV检测筛查患者347例,其中可疑的患者80例。80例可疑患者均行阴道镜检查,取宫颈活体组织检查(活检)及病理组织诊断。对80例可疑样本进行回顾性分析,对比样本的薄层液基细胞学检查、HPV检测与阴道镜检查病理组织诊断等结果。结果(1)薄层液基细胞学检查与HPV检测结果对比显示,按薄层液基细胞学检查TBS分类标准,级别越高,HPV检测阳性率越高(χ~2=134.04,P<0.01)。(2)在病理诊断与薄层液基细胞学检查、HPV检测结果对比中,重度不典型增生(CINⅢ)组以及鳞状细胞癌(SCC)组较轻度不典型增生(CINⅠ)组与中度不典型增生(CINⅡ)组检测阳性率高(χ~2=9.74、8.83,P<0.01)。(3)薄层液基细胞学检查与HPV联合检测,CINⅢ检出率达93.75%(15/16),较SCC、CINⅠ、CINⅡ高(χ~2=8.18,P=0.04),但依然存在漏检的发生。结论采用薄层液基细胞学检查、HPV检测联合阴道镜检查可较好地提高宫颈癌检出率,具有较高的临床诊断价值,但依然存在漏检的可能。

Objective To explore the application value of liquid-based cytology test and human papillomavirus（HPV） detectoin combined with colposcopy in clinical screening of cervical carcinoma.Methods A total of 347 patients were selected from the hospital from June 2014 to June 2016,after liquid-based cytology test and HPV detection,80 patients were suspected of cervical carcinoma.Then the 80 patients were examined by colposcopy and cervical biopsy,pathological examination was performed,the clinical data of these 80 patients were analyzed retrospectively.The results of liquid-based cytology test and HPV examination,colposcopic pathological examination were compared.Results Compared with HPV detection,according to liquid-based cytology test classification standard,the higher TBS level was,the higher positive rate of HPV was（χ~2= 134.04,P〈 0.01）.Comparing the pathological diagnosis,liquid-based cytology test and HPV examination results,the detection positive rates in cervical intraepithelial neoplasia（CIN） Ⅲ group and squamous cell carcinoma（SCC）group were statistically significantly higher than those in CIN Ⅰ group and CIN Ⅱ group（χ^2= 9.74,8.83,P〈 0.01）.After the joint detection of liquid-based cytology and HPV test,the detection rate of CIN Ⅲ was 93.75%（15/16）,which was statistically significantly higher than those of SCC,CIN Ⅰ,and CIN Ⅱ（χ^2= 8.18,P = 0.04）,but the possibility of missed diagnosis still existed.Conclusion The detection rate of cervical carcinoma can be improved by liquid-based cytology test,HPV detectoin combined with colposcopy has relatively high clinical value,but the possibility of missed diagnosis still exists.