TCT联合高危HPV检测在宫颈癌前病变诊断中的应用评估

The Application of TCT Combined with High Risk HPV in the Diagnosis of Cervical Precancerous Lesions

目的:探究液基薄层细胞学(TCT)联合高危人乳头瘤病毒(HPV)检测在宫颈癌前病变诊断中的应用价值。方法:回顾性分析2019年4月-2020年1月深圳恒生医院行宫颈癌前病变筛查的576例患者的临床资料,全部患者均进行TCT与高危HPV检测,以宫颈病理活检为金标准,分析TCT联合高危HPV检测对宫颈癌前病变的诊断价值。结果:病理活检诊断结果为112例阳性,包括16例CINⅠ级、27例CINⅡ级、38例CINⅢ级和31例浸润癌;TCT检测结果为326例阳性,227例误诊,13例漏诊;高危HPV检测结果为362例阳性,261例误诊,11例漏诊。病理分类为浸润癌患者的TCT与高危HPV检测阳性率均为100%,均高于病理分类为CINⅠ的患者(P<0.05)。TCT与高危HPV联合检测的敏感性(94.64%)和阴性预测值(97.12%)最高。结论:TCT联合高危HPV检测的敏感性和阴性预测值均高于单独检测,联合检测在颈癌前病变诊断中具备较高临床价值,值得推广应用。

Objective:To investigate the value of liquid-based thin layer cytology (TCT) combined with high risk human papillomavirus (HPV) in the diagnosis of cervical precancerous lesions.Method:The clinical data of 576 patients who were screened for cervical precancerous lesions in Shenzhen Hengsheng Hospital from April 2019 to January 2020 were analyzed retrospectively.All patients were tested with TCT and high-risk HPV.The diagnostic value of TCT combined with high-risk HPV in cervical precancerous lesions was analyzed based on the gold standard of cervical pathological biopsy.Result:The results of pathological biopsy were 112 cases,including 16 cases of CIN Ⅰ,27 cases of CIN Ⅱ,38 cases of CIN Ⅲ and 31 infiltrating cancer;the results of TCT were 326,there were 227 misdiagnosed and 13 missed;362 were positive in high risk HPV,261 were misdiagnosed and 11 missed.The positive rates of TCT and high risk HPV were 100% in pathological classification as infiltrating cancer,which were significantly higher than those of CIN Ⅰ.The sensitivity (94.64%) and negative predictive value (97.12%) of TCT combined with high risk HPV were the highest.Conclusion:The sensitivity and negative predictive value of TCT combined with high-risk HPV detection are higher than that of single detection,and the combined detection has high clinical value in the diagnosis of cervical precancerous lesions,which is worthy of popularization and application.