TCT、HPV检测及阴道镜检查在宫颈癌前病变与宫颈癌筛查中的临床意义

Clinical significance of TCT,HPV detection and colposcopy in screening cervical precancerous lesions and cervical cancer

目的 分析薄层液基细胞学(TCT)检测、高危型人乳头瘤病毒(HPV)及阴道镜检查在宫颈癌前病变与宫颈癌筛查中的临床意义。方法 选取1269例宫颈癌筛查者,均实施TCT、HPV检测,对其中75例高度可疑者实施阴道镜检查,分析TCT、HPV早期诊断宫颈癌效果。结果 75例宫颈细胞学检测结果异常者中,不典型鳞状上皮细胞(ASC)30例(40.00%),低度鳞状上皮内病变(LSIL)25例(33.33%),高度鳞状上皮内病变(HSIL)18例(24.00%),鳞状细胞癌(SCC)者2例(2.67%),HPV检测显示阳性率29.33%(22/75)。TCT显示异常者中,经HPV检查显示39例阳性者,阳性率为52.00%(39/75),其中ASC患者10例(33.33%),LSIL患者14例(56.00%),HSIL患者13例(72.22%),癌症患者有2例(100%);TCT+HPV阳性预测值89.74%,显著高于HPV或TCT单一检测的阳性预测值(P<0.05)。结论 TCT、HPV检测在宫颈疾病的筛查中具有不同应用价值,需依据患者具体病情及经济状况合理选择筛查方式,联合检测阳性率更高。

Objective To analyze the clinical significance of thin layer liquid based cytology(TCT), high-risk human papillomavirus(HPV) and colposcopy in screening cervical precancerous lesions and cervical cancer. Methods A total of 1269cervical cancer screening cases were selected, all of which were tested by TCT and HPV, and 75 highly suspicious cases were tested by colposcopy to analyze the effect of early diagnosis of cervical cancer by TCT and HPV. Results Among the 75 cases with abnormal cervical cytological results, 30 cases(40.00%) were atypical squamous epithelial cells(ASC), 25 cases(33.33%)were low-grade squamous intraepithelial lesions(LSIL), 18 cases(24.00%) were highly squamous intraepithelial lesions(HSIL), and 2 cases(2.67%) were squamous cell carcinoma(SCC). HPV test showed a positive rate of 29.33%(22/75). Among the patients with abnormal TCT, 39 were positive by HPV test, with a positive rate of 52.00%(39/75), including 10 ASC patients(33.33%), 14 LSIL patients(56.00%), 13 HSIL patients(72.22%), and 2 cancer patients(100%);The positive predictive value of TCT+HPV was 89.74%, which was significantly higher than that of HPV or TCT alone(P<0.05). Conclusion TCT and HPV detection have different application values in cervical disease screening. It is necessary to select a reasonable screening method according to the specific condition and economic status of patients, and the positive rate of combined detection is higher.