细胞学联合病原微生物检测筛查宫颈癌的临床应用研究  

Combined application of liquid-based cytology and pathogenic microbes in the detection of cervical cancer

作　　者：黄卫彤[1] 韦红卫[2] 黄玮[1] 吴惠珍[2] 常正义[1] 韦英群[3] 

机构地区：[1]广西右江民族医学院医学检验系,广西百色533000 [2]广西右江民族医学院妇产科教研室,广西百色533000 [3]广西右江民族医学院病理教研室,广西百色533000

出　　处：《中国实验诊断学》2004年第5期507-509,共3页Chinese Journal of Laboratory Diagnosis

基　　金：广西百色市科学研究与技术开发计划项目基金 (NO2 0 0 3 0 8)资助

摘　　要：目的　探讨Thinprep宫颈液基细胞学联合病原微生物DNA检测筛查宫颈癌临床应用价值 ,了解与肿瘤相关的病原微生物的感染状况。方法　对 5 5 2例宫颈病变者 ,用液基标本做薄片细胞学诊断和人乳头瘤病毒 (HPV)、疱疹病毒 (HSV Ⅱ )、沙眼衣原体 (CT)、解尿支原体 (UU)DNA检测。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 ,诊断阳性者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) 4 5例 ,与阴道镜活检阳性符合率分别为10 0 % (5 / 5 )的SCC ,93 3% (70 / 75 )的HSIL ,78 9% (45 / 5 7)的LSIL。PCR荧光法检出HPV、HSV Ⅱ、CT、UUDNA感染率分别为 2 1 0 % (116 / 5 5 2 ) ,10 3% (5 7/ 5 5 2 )、2 1% (116 / 5 5 2 )、16 % (88/ 5 5 2 ) ,92例HPV感染者细胞学诊断≥ASCUS ,占病理活检阳性率的 6 6 7% (92 / 138)。结论　宫颈液基细胞标本收集方法 ,一次性取材能做细胞学和病原微生物 (HPV、HSV Ⅱ、CT、UU)DNA检查。Thinprep液基细胞学联合病原微生物DNA检测 ,能提高宫颈癌和癌前病变的诊断率 ,是宫颈癌筛查的重要手段。HPV感染是宫颈癌及癌前病变发生发展的首要因素 ,HSV Ⅱ、CT、Objective To investigate the efficacy of combining liquid-based cytology(ThinPrep Pap Test) and pathogenic microbes. Methods This study was performed on 552 cases of cervical cancer. Exfoliative cervical samples was taken from all subjects. Cervical samples were collected into a liquid buffer for both ThinPrep Pap Test cytologic screening and human papilloma virus(HPV), HSV-Ⅱ, CT, UU DNA test. The positive results were compared with those of colposcopic biopsies. Results 5 cases of squamous cell carcinoma(SCC) and 70 cases of high grade squamous intraepithelial lesions(HSIL) and 45 cases of low grade squamous intraepithelial lesions(LSIL) were detected by ThinPrep. The consistent rate with biopsy were 100%, 93 3% and 78 9% respectively. Microbes DNA test positive rate:HPV(21 0%), HSV-Ⅱ(10 3%), CT(21%), UU(16%). Conclusion Cervical specimens collected into a liquid buffer are suitable for both cytologic screening and pathogenic microbes virus test. Combining the two tests can increase the diagnosis of cervical carcinoma.

关 键 词：宫颈癌 UU HSV 病原微生物 筛查 联合 诊断 细胞学 辅助因子 DNA 

分 类 号：R737.33[医药卫生—肿瘤] R711[医药卫生—临床医学]