宫颈高级别上皮内瘤变和宫颈癌患者的TCT和hrHPV结果分析

TCT and hrHPV Analysis of Patients with High-Grade Cervical Intraepithelial Neoplasia and Cervical Cancer

目的分析宫颈高级别上皮内瘤变(HSIL)和宫颈癌患者的细胞学和高危人乳头瘤病毒(hrHPV)分型特征和差异。方法回顾性分析2018年1月-2019年12月就诊的194例HSIL和122例宫颈癌患者的临床资料。患者均行宫颈液基薄层细胞学(TCT)及hrHPV分型检查。结果194例HSIL患者中,TCT阳性166例(85.57%),HPV阳性189例(97.42%),两者联合筛查阳性为193例,阳性率为99.48%(193/194)。122例宫颈癌患者中,TCT阳性102例(83.60%),HPV阳性113例(92.62%),两者联合筛查阳性为119例,阳性率为97.54%(119/122)。HSIL患者最常见的HPV类型是HPV16及HPV58,宫颈癌患者最常见的HPV类型是HPV16及HPV18,HPV16/18在宫颈癌中的总感染率为73.77%。结论TCT单独筛查较HPV单独筛查更易漏诊HSIL和宫颈癌,联合筛查可显著提高检出率。HPV16/18是宫颈癌最关键的诱发因素,在HSIL中HPV58感染较HPV18更常见。

Objective To analyze the distribution and difference in between thinprep cytology test and high risk human papillomavirus screening in cervical high squamous intraepithelial lesion and cervical carcinoma.Methods A retrospective analysis was conducted based on the clinical data of 194 patients with cervical high squamous intraepithelial lesion and 122 patients with cervical carcinoma,who were treated in the Union Hospital of Fujian Medical University between January 2018 and December 2019.All of the patients involved underwent thinprep cytology test(TCT)and high risk human papillomavirus(hrHPV)screening.Results Among the 194 cases with cervical HSIL,the TCT results were positive in 166 cases(85.57%),hrHPV results were positive in 189 cases(97.42%),and there were 193 cases(99.48%,193/194)wherein both TCT and hrHPV results were positive according to joint screening.Among the 122 cases with cervical carcinoma,the TCT results were positive in 102 cases(83.60%),hrHPV results were positive in 113 cases(92.62%),and there were 193 cases(99.48%,193/194)wherein both TCT and hrHPV results were positive according to joint screening.The most prevalent HPV types in cervical HSIL were HPV16,HPV58,while the most prevalent HPV types in cervical carcinoma were HPV16,HPV18,HPV16/18 were positive in 73.77%of patients with cervical carcinoma.Conclusions Single use of TCT screening leads to more frequent missed diagnosis of high-grade lesions compared with single use of hrHPV screening,while joint use of both screening methods can improve the detection rate.HPV16/18 infection is the important cause of cervical carcinoma.The constituent ratio of HPV 58 is higher than HPV18 in cervical HSIL.