HPV、TCT及阴道镜对宫颈癌筛查的意义

Significance of HPV, TCT and Colposcopy for Cervical Cancer Screening

目的对HPV、TCT及阴道镜在宫颈癌早期筛查中的作用进行探讨。方法选取2015年7月—2017年7月在该院接受宫颈癌筛查的5 151例患者进行HPV、TCT及阴道镜宫颈下活检,通过病理组织学诊断标准检查检测结果。结果 HPV与TCT比较,差异无统计学意义(χ~2=1.279,P>0.05);阴道镜检出率100.00%显著高于HPV与TCT,差异有统计学意义(χ~2=55.045,χ~2=68.082,P<0.05)。采用病理组织学评定检查,结果表明病变患者中TCT及HPV对于鳞状细胞癌的检测结果呈阳性的诊断符合率为100.00%,其次病变越严重的TCT、HPV联合检测的诊断符合率越高;病患采用TCT检测的漏诊率为23.92%,HPV检测的漏诊率为14.98%,而通过联合检测的漏诊率为2.88%;联合检测漏诊率与单独HPV、TCT比较,差异有统计学意义(χ~2=31.242,χ~2=66.167,P<0.05)。结论 HPV、TCT检查在早期宫颈癌诊断中高效、可行,联合阴道镜检测对提高宫颈癌及癌前病变诊断检出率具有重要意义。

Objective To investigate the role of HPV, TCT and colposcopy in early screening of cervical cancer. Methods A total of 5,151 patients who underwent cervical cancer screening in the hospital from July 2015 to July 2017 were enrolled in the HPV, TCT, and colposcopy biopsy. The results were examined by histopathological diagnostic criteria. Results There was no statistically significant difference between HPV and TCT (χ^2= 1.279, P>0.05). The colposcopy detection rate was 100.00% higher than HPV and TCT, and the difference was statistically significant (χ^2=55.045,χ^2=68.082, P<0.05). Histopathological evaluation showed that the diagnostic coincidence rate of TCT and HPV positive for squamous cell carcinoma was 100.00%. The more serious the secondary lesion, the higher the diagnostic coincidence rate of TCT and HPV combined detection. The missed diagnosis rate of patients using TCT test was 23.92%, the missed diagnosis rate of HPV test was 14.98%, and the missed diagnosis rate by joint test was 2.88%. The difference between missed diagnosis rate and HPV and TCT alone was statistically significant (χ^2=31.242,χ^2=66.167, P<0.05). Conclusion HPV and TCT are effective and feasible in the diagnosis of early cervical cancer. Combined with colposcopy, it is of great significance to improve the detection rate of cervical cancer and precancerous lesions.