宫颈癌前病变HPV感染与宫颈液基细胞早期筛查的临床分析

Clinical analysis of HPV infection and cervical liquid based cell early screening of cervical precancerous lesions

目的探究对宫颈癌前病变患者高危型人乳头瘤病毒(HPV)与宫颈液基细胞学检测早期筛查的效果。方法选择2014年3月-2017年3月在医院就诊的240例宫颈病理变化患者为研究对象,所有患者均采用高危型HPV检查和宫颈液基细胞学检查,进行早期宫颈癌前病变筛查并分析。结果在240例患者中,高危型HPV感染的阳性例数20例,阳性率8.33%,其中HPV16型占50.00%,HPV18型占30.00%,HPV58型占10.00%,HPV33型占5.00%,HPV31型占5.00%;TBS诊断报告显示,异常涂片19例占7.92%;不典型鳞状细胞(ASC)占4.17%,鳞状细胞癌(SCC)占0.83%,鳞状细胞癌(LISL)占1.25%,高度鳞状上皮内病变(HSIL)占0.83%,不典型腺细胞(AGC)占0.83%,ASC、AGC与LSIL细胞学病理检查结果比较,差异有统计学意义(P<0.05);HPV16与HPV18检测阳性数与宫颈组织活检病理结果进行比较,HPV16与HPV18在炎症轻度宫颈癌前病变(CNⅠ)、中度宫颈癌前病变(CNⅡ)、高度宫颈癌前病变(CNⅢ)与癌中阳性比较均有统计学意义(P<0.05)。结论高危型HPV检查能提高宫颈癌前筛查的准确率,高危型HPV检测联合宫颈液基细胞学检测应用于早期宫颈癌前病变筛查中,能提高宫颈癌前病变筛查率,且具有科学性和准确性。

OBJECTIVE To investigate the effect of early screening of high-risk human papillomavirus（HPV）and cervical liquid based cytology test in patients with cervical precancerous lesions.METHODS A total of 240 cases of patients with cervical pathological changes in hospital from Mar.2014 to Mar.2017 were selected as the research objects.All patients were screened for early cervical precancerous lesions by high-risk HPV examination and liquid based cytology test.RESULTS Among the 240 patients,the number of positive cases of high-risk HPV infection was 20,and the positive rate was 8.33%.Among them,HPV16 type accounted for 50.00%,HPV18 type accounted for 30.00%,HPV58 type accounted for 10.00%,HPV33 type accounted for 5.00%,and HPV31 type accounted for 5.00%.TBS diagnostic report showed abnormal smears in 19 cases,accounting for 7.92%.The atypical squamous cells（ASC）accounted for 4.17%,squamous cell carcinoma（SCC）accounted for 0.83%,squamous cell carcinoma（LISL）accounted for 1.25%,high grade squamous intraepithelial lesion（HSIL）accounted for 0.83%,and atypical glandular cells（AGC）accounted for 0.83%.Comparison of cytological pathological examation results between ASC,AGC and LSIL,the difference was significant（P 0.05）.Comparison of positive numbers of HPV16 and HPV18 and pathological results of cervical tissue biopsy,HPV16 and HPV18 in mild inflammation of cervical precancerous lesions（CNⅠ）,moderate cervical precancerous lesions（CNⅡ）,high cervical precancerous lesions（CNⅢ）and carcinoma tissues were significant（P〈0.05）.CONCLUSION High-risk HPV test can improve the accuracy of screening for cervical cancer,and detection of high-risk HPV combined with cervical liquid based cytology test used in the screening of early cervical precancerous lesions,can improve the screening rate of cervical precancerous lesions,and is of high scientificity and accuracy.