早期宫颈上皮内瘤变患者HPV、TCT检查的临床价值分析

Clinical value of HPV test and TCTforpatients with early cervical intraepithelial neoplasia

目的研究分析早期宫颈上皮内瘤变患者HPV、TCT检查的临床价值。方法选取2014年2月至2015年2月海南省妇幼保健院筛查的290例宫颈上皮内瘤变患者作为研究对象。采用膜式液基薄层细胞学(TCT)技术进行宫颈上皮内瘤变(CIN)筛查,检测高危型HPV-DNA,并同时进行阴道镜检查,以组织病理学检测结果为标准。结果 290例患者中,检出123例HPV-DNA阳性患者(阳性率为42.41%);TCT检测出143例阳性涂片(占49.31%),其中70例不典型鳞状上皮细胞(ASCUS,占48.95%);这70例ASCUS中,组织病理学诊断共6例CINⅡ、CINⅢ(占8.57%)和50例LSIL(占71.42%);这50例LSIL中,组织病理学诊断共24例CINⅡ、CINⅢ(占48.00%)和23例HSIL(占46.00%);这23例HSIL中,组织病理学诊断共20例CINⅡ、CINⅢ(占86.96%)。随着细胞学诊断的提高,CIN检出率也显著增加,差异具有统计学意义(P<0.05)。290例宫颈上皮内瘤变患者的最终组织病理学诊断:290例宫颈上皮内瘤变患者中有慢性宫颈炎患者162例,其中有HPV-DNA阳性22例(占13.58%);290例宫颈上皮内瘤变患者中还有CINⅢ18例(占9.38%),这18例CINⅢ中,有HPV-DNA阳性17例(占94.44%)。随着患者病情的加重,HPV-DNA阳性检查率越来越高,差异具有统计学意义(P<0.05)。结论给予早期宫颈上皮内瘤变患者采用HPV-DNA、TCT联合阴道镜检查,具有便捷、高效的优势,能够提高阳性检出率,减少误诊及漏诊率,从而有利于医师对患者的及时阻断性宫颈癌治疗,提高患者的生存率。

ObjectiveTo analyzethe clinical value of human papillomavirus (HPV) test and thinprepcytologic test (TCT)forpatients with early cervical intraepithelial neoplasia (CIN). Methods290 patients with cervical intraepithelial neoplasia in our hospital from February 2014 to February 2015were selected as research objects. Screening of CINwas performed by membrane-based TCT for thedetection of high risk HPV-DNA. Meanwhile, colposcopy was performed, and the results of histopathological examination were taken as the standard. ResultsAmong the 290 patients, HPV-DNA positive were detected in 123 cases, the positive rate of 42.41%. Among the 143 positive smears detected by TCT, there were 70 cases of atypical squamous cells (ASCUS), including 6 cases of CIN II, CIN III (8.57%)diagnosed histopathologically, 50 cases of LSIL including 24 cases of CIN II, CIN III (48.00%) diagnosed histopathologically, and 23 cases of HSIL including 20 cases of CIN II, CIN III (86.96%). With the improvement of cytological diagnosis, the detection rate of CIN was significantly increased, with statistically significant difference (P<0.05). According to histopathological diagnosis, there were 162 cases of chronic cervicitis including 22 cases (13.58%) of HPV-DNA positive, 18 cases of CIN Ⅲ including 17 cases (94.44%)of HPV - DNA positive . With the aggravation of the patient′s condition, the positive rate of HPV-DNA increased with statistically significant difference(P<0.05).ConclusionsHPV-DNA and TCT combined with colposcopy is convenient and efficient in the detection of early cervical intraepithelial neoplasia, which can improve the positive rate, reduce the rate of missed diagnosis and misdiagnosis, hereby conductive to timely blocking cervical cancer and improving the survival rate of patients.