液基细胞学联合病原微生物检测筛查宫颈癌的实验研究

Combining detection of liquid-based cytology and pathogenic microbes for cervical carcinoma screening

目的评价ThinPrep宫颈液基细胞学联合病原微生物DNA检测筛查宫颈癌的临床价值。方法对552例宫颈高危患者进行液基细胞学诊断和病原微生物DNA检测,包括人乳头瘤病毒.疱诊病毒、沙眼衣原体、解脲支原体。细胞学诊断采用TBS分级系统,阳性诊断包括意义不明确的不典型鳞状细胞(ASCUS)以上病变,并以阴道镜活检诊断为对照。结果细胞学检出鳞状细胞癌(SCC)5例,鳞状上皮内高度病变(HSIL)70例,鳞状上皮内低度病变(LSIL)45例,与阴道活检阳性符合率分别为:SCC100%(5/5),HSIL93.3%(70/75),LSIL78.9%(45/57)。PCR检出HPVDNA感染率为21.0%(116/552),其中细胞学阳性者占SCC100%(5/5)、HSIL76.0%(57/75),LSIL52.6%(30/57),占总阳性率的67.2%(92/137);HSV-Ⅱ、CT、UUDNA检出率分别为10.3%(57/552)、21%(116/552)、16%(88/552),细胞学阳性者共24例,占总阳性率17.5%(24/137)。结论采用ThinPrep宫颈液基细胞标本收集方法,做细胞学和相关病原微生物DNA联合检查。

Objective To evaluate the efficacy of cervical lesions with combining detection of liquid-based cytology and pathogenic microbes.Methods552samples of cervical sevretion from high-risk of cervical carcinoma were respectively collected for both exfoliative cytology by Thin Prep Pap Test and the detections of pathogenic DNA by PCR,including HPV,HSV- Ⅱ ,CT and UU.The positive results were compared with those of colposcopic biopsies.Results5cases of squamous cell carcinoma(SCC),70cases of high grade squamous intraepithelial lesions(HSIL)and45cases of low grade squamous intraepithelial lesions(LSIL)were detected according to The Bethesda System.The corresponding rates between cytology and colposcopic biopsy were100%,93.3%and78.9%respectively.The infectious rate of HPV-DNA was21.0%,with10.3%of HSV- Ⅱ ,21%of CT,16%of UU.Conclusions Combining detection of liquid-based cytology and cor responding pathogenic microbes is suitable for cervical carcinoma screening.It can increase the diagnostic rate of cervical carcinoma.