高危型人乳头瘤病毒与薄层细胞学联合检测在宫颈病变中的相关性研究

Clinical Relevance of HR-HPV DNA detecting and TCT test for cervical lesions

目的 探讨高危型人乳头瘤状病毒（HR-HPV）与液基薄层细胞学（TCT）技术联合检测对宫颈癌前病变及宫颈癌的诊断价值和临床意义.方法 回顾性分析2015年11月至2016年5月间就诊于上海市仁济医院南院妇产科筛查HPV患者共1518例,其中高危型HPV感染患者504例,筛选其中TCT分类≥ASCUS的患者共49例,统计高危型HPV阳性率及高发亚型,同时比较分析高危型HPV与TCT检测结果的相关性.结果 高危型HPV感染率为33.2%,位居前三位的高发型别分别为HPV 52型,58型和16型.高危型HPV感染且TCT分级为ASCUS,LSIL和HSIL的患者依次为23例,18例和8例.利用SPSS 17.0中的卡方检验分析可得,TCT分级与HPV 58型具有显著相关性.结论 TCT检测能有效降低宫颈癌发病率,但由于其灵敏度较低,会造成部分漏诊.高危型HPV与TCT联合检测能够显著提高宫颈癌前病变和宫颈癌的检出率,具有重要临床应用价值.

Objective To investigate the clinical value of combination test of high-risk HPV（HR-HPV） and thinprep cytologic test（TCT） in the pre-cancerous lesions and cervical cancer.Methods 1518 cases of HPV-detected patients were selected and analyzed in gynaecology and obstetrics in South division of Renji hospital between November 2015 and May 2016.There were 504 cases of HR-HPV infection,and 49 cases of higher than ASCUS in TCT.HR-HPV positivity and sub-types occurred frequently were analyzed,and the relationship between HR-HPV and TCT was detected.Results The positivity of HR-HPV infection was 33.2%,and the top three sub-types occurred frequently ware HPV-52,58 and 16,respectively.HR-HPV infected patients with ASCUS,LSIL and HSIL degree in TCT were 23,18 and 8 cases,respectively.TCT and HPV58 have significant relationship by spearman analysis.Conclusion TCT can reduce the incidence of cervical cancer effectively.However,low sensitivity in the low-grade cervical lesions may cause missed diagnosis.Combination of TCT and HR-HPV test will improve the detection rate of pre-cancerous lesions and cervical cancer,which has important clinical value.